LCM LADY BEAR VOLLEYBALL CAMP

July 14 – 17, 2008

Monday – Thursday

Grades – 5^th, 6^th and 7^th(2008-2009 school year)

9:00 a.m. – 12:00 a.m.

$50

Located at the LCM High School Gym

Camp director: Vicki Castino Camp Features: T-Shirt

Fundamentals

Strategies/Competition

-------------------------PLEASE CUT AND KEEP TOP PORTION FOR YOUR RECORDS------------------------------------------------

Lady Bear Camp Application and Consent Form

Please return form and $50 check made payable to:

Vicki Castino

3593 FM 1136

Orange, TX 77632

745-3102

Name_______________________________________Age________Grade in Fall 08_________

Address___________________________________City__________________Zip____________

Parent’s home phone____________________________Work Phone_______________________

e-mail address___________________________________T-Shirt Size (Adult)_______________

I certify that _____________________________has my permission to participate in the Lady Bear Volleyball Camp. I authorize the camp director to act for me according to her best judgment requiring medical attention. I hereby waive and release the Lady Bear Volleyball Camp Staff and LCM C.I.S.D. from liability for injury. I know of no mental or physical problems that affect my child’s ability to safely participate in this camp. I certify that the mentioned child has medical insurance in case of emergency.

Please list any know medical conditions, medication, and/or allergies:______________________

______________________________________________________________________________

Signed (Parent or Guardian)___________________________________Date________________