KIDS SPORTS ZONE – February Break CAMP 16-20 & Monday 23rd
Camp is for kids ages 2-6 years of age. And will be divided up into appropriate groups.
TIME OPTIONS ARE 8:30-12 ($35) 8:30-2 ($50)
PLEASE CIRCTLE DAY(S) AND WRITE IN TIMES. or EMAIL TO SIGN UP & PAY KidsSportsZone@gmail.com
Monday Tuesday Wednesday Thursday Friday Monday (23rd)
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Kids Sports Zone Waiver
Name of Participant: _____________________________________DOB: __________ M/F
Contact Information for Participant
Parent -First Name/Last Name: _____________________________Email Address:__________________
Address: _______________________________________Town/City: __________________________ Home Phone: __________________________Cell Phone or Best Number to be reached: ____________
Emergency Contact
First Contact Name: _________________________________ Relationship: ____________________
Number:___________________________
Second Contact Name: _______________________________ Relationship: _____________________
Number:____________________________________
Please list any allergies, medications, or special health considerations we should be aware of:___________________________________________________________________________________
Waiver of Participant by parent or self: In consideration of your accepting my or my child’s registration and entry, I hereby for myself,my child, my heirs, executors and administrators, waive and release any and all rights and claims for damages I or my child may have against Integrated Sports Training, Growing Tree Yoga, or Sara Holland; and its representatives, successors and assigns, for any and all injuries suffered by myself or my child at the activity sponsored by these groups. I understand there is inherent risk associated with the(se) activity(ies) and authorize emergency medical treatment and transportation in my absence. If any of the above participants are minors, I certify by my signature that I am the custodial parent or guardian; or I have the expressed authorization of the custodial parent, or guardian to enroll said participant(s) in the specified activities listed.
SIGNATURE OF PARENT/GUARDIAN DATE _________________________________________
KidsSportsZone@gmail.com