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First Name:Last Name:
Address:
City:StateZIP
GradeAgeD.O.B.M or F
School
Sports
Parents Name
Home # Work # Cell #
E-Mail
Referred by
4th & 5th, and Middle School High School/College
4th & 5th grade: Mon 4pm-5pm, Wed 4:00pm-5:00
Morning sessions: T & T, 9am-11am (summer only)
Evening sessions: T & T, 6:30pm-7:30pm
Saturday sessions: 11:00am-12:00am
Morning sessions: M & W, 9am-11am (summer only)
Evening sessions: M & W, 6:30pm-7:30pm
Saturday sessions: 10:00am-11:00am

 
I authorize my child to participate in this camp or training sessions. I voluntarily assume all risk of accident or injury to my child which may arise out of their participation in this program and therefore release and hold harmless The Sports Training Center and Speed School, NBS, Acworth Youth Sports and all personnel associated with this program from any and all liability that may result from my childs participation. In addition, I hereby give my permission for emergency medical treatment in the event I cannot be reached.
 
Comments/Notes: