Colonial Field Hockey Club - Williamsburg, VA

Advertise Here!⇒

⇐Advertise Here!

Players Name:
Parent/Guardian Name:
Address:
City:
State:
Zip Code:
Campers Cell:
Parent/Guardian Cell:
Primary Contact Email: (Required)
School:
Age @ Camp:
Grade:
Position:
Playing Level:
Dates Attending:	Mon., Jun. 21 2010 Tue., Jun. 22, 2010 Wed., Jun. 23, 2010 Thur., Jun. 24, 2010
I hereby give permission for my child to be medically treated for injuries or illness during participation in the Reach Athletic Development, llc/Colonial F.H. camp. I also acknowledge that the camper above is healthy and has no physical problems that would prevent participation in the camp. Primary insurance coverage rests with the camper, parents and or guardian.
Insurance Company:
Insurance Policy Number:
Please fill out the following Medical Form and Bring It To The Event:	Registration/Medical Form Download
Parent Signature (If under 18):
Date:
Please choose payment method: (Instructions on the next page)	Paypal Mail Payment

Registration for 2010 RAD DAY CAMP@ W&M Busch Field

757 - 450 - 1086

reachhockey@aol.com