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Sean Collins' Sports by gegeshandong


									                           Sean Collins’ Sports
                            Registration Form

First Name                  Last Name ________________D.O.B. _______

Address ___________________________________City _______________

Zip ________ Cell Phone ________________Home __________________

Email______________________ _ Emergency Contact ________________

Emergency Cell Phone ________________________


                     *Waiver & Release Form
"I hereby authorize Sean Collins and staff to act for me according to their
best judgment in any emergency requiring medical attention and I hereby
waive and release all entities of Sean Collins’ Sports from any and all
liability for any injuries or illnesses incurred during the camp. I have no
knowledge of any physical impairment that would affect my child’s
participation with Sean Collins’ events, and according to our family
physician, our child is fit to participate in all camp/clinic/private instruction
activities. Also, we do have medical insurance in case my child is in an
accident. I have read the above regulations of Sean Collins’ Sports and I
agree to abide by them."

Parent/Guardian Signature________________________ Date _________

                             Make Checks Payable To:
                                 Sean Collins

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