Summer Writing Camp 2008- Registration Form

Summer Writing Camp 2009- Registration Form Please complete this form and mail it, with a check for $160, to: Annie Gage, 5657 Keystone Pl. N., Seattle WA 98103 Child______________________________________________ Grade in Sept. ‘09_______ School_____________________ Parent/Guardian(s) _________________________________ Address___________________________________________ _________________________email____________________ Tel. (h) ______________ (w) _____________ cell___________ Health Concerns? ___________________________________ Registering for Session:  1 (July 20-24)________  2 (July 27-30)_________ The risks at Summer Writing Camp are negligible. However, we will play and walk outdoors. Therefore, I request that parents sign a release form. I authorize Annie Gage to act for me in her best judgment in any emergency requiring medical intervention. Participants assume all risks associated with normal participation in Summer Writing Camp and those inherent in walking and playing in an outdoor, urban environment. Parent/Guardian signature__________________________________date___________