Please fill out and return this portion to register.  The cost of the camp is $125.00 per child.  Make checks or money orders payable to “Curtis Baham’s Special Events” and mail to P. O. Box 13415, New Orleans, LA 70185

 

Child’s Name: ______________________________________                 ______________       Childs age: _____________       Grade: _____________

 

Address: ___________________________________________              City: ______________________________   Zip: _______________

 

Phone #: __________________________ Emergency Contact: _______________________   Emergency #: ________________________

 

Football
      Cheer leader 
  Position : _____________________________  T-shirt size: ___________

List below any medical information that we need to know about your child. Asthma, Pre-existing injury currently under treatment, Fractures or other disability type injuries, Allergies, Mental disorder, Birth Deformities, Contacts or glasses.

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I hereby give my child _________________________________________ permission to participate in the “Curtis Baham’s Celebrity Football Camp”.  I understand that I will be fully responsible for any medical emergencies that my child may need during this camp, and by signing this form, I free the camp from all expenses in case of injury.  I also give the temporary authority of any medical attention needed for my child to the paramedics until I can be contacted of any injuries my child may have.

 

Print Parent Name: ____________________________         Parent’s Signature: ____________________________    Date:_____________

 

I would like my child ________________________________________ to ride the bus to the camp for an additional $8.00 dollars.  I understand that I must sign the BUS ATTENDANCE SHEET in order for my child to get on the bus that will leave at 7:00 a.m.; And I also understand that I must sign my child out once he/she gets off the bus at 6:00 p.m.  I understand that Curtis Baham’s Special Events is providing transportation by an outside licensed bus company and is not liable for any injuries that can occur to and from the camp.  By signing below, I relieve Curtis Baham’s Special Events of any and all liabilities that may occur on any of the buses.

 

Print Parent Name: ____________________________         Parent’s Signature: ____________________________    Date:_____________