Sports Camp Registration

* = Required field
 
*Please check all camps you plan to attend:
  Boys' Basketball - Grades 5-8, $175
  Boys' Basketball - High School, $175
  Girls' Basketball, $150
  Boys' Soccer, $150
  Girls' Soccer, $150
  Girls' Volleyball - High School, $200
  Girls' Volleyball - Jr. High 1, $200
  Girls' Volleyball - Jr. High 2, $200
 
*Name
*Grade next school year
*Home Address
*City
*State
*Zip xxxxx-xxxx
*Day Phone xxx-xxx-xxxx
*Night Phone xxx-xxx-xxxx
 What church do you attend?
*What school will you attend next school year?
*Adult t-shirt size S M L XL XXL
Position
*Email Address
 Roommate Preference
 Is either parent a LCU alumni?
 
INSURANCE INFORMATION: Must be completed in order to attend camp. I will be covered by my personal, family accident or illness insurance.
*Name of Insurance Provider
*Policy Number
 
RELEASE STATEMENT: We, the undersigned parents / legal guardians of , a minor, do hereby certify that said minor ies physically fit and medically capable of participating in all camp activities and has had a physical exam verifying physical fitness in the last year. We further agree to advise LCU of any changed medical condition between the time of application and the time of the camp. We further authorize the Director of LCU Sports Camp to authorize medical treatment for said minor. We agree to be responsible for all costs incurred for this treatment.
 
*Signature of Parent or Guardian
*Date
Please sign the Release by typing your full name above.