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NAME ______________________________________________________
GRADE (Fall 2011)____________________
STREET_______________________________________CITY____________________STATE_____
ZIP____________
BIRTH
DATE_______________AGE____SEX____HEIGHT_____WEIGHT_____POSITION_______________________
SCHOOL_______________________________________PARENT’S
NAME___________________________________
HOME
PHONE__________________________________EMERGENCY PHONE_________________________________
T-Shirt
SIZE (Men’s) XS S M L
XL (please circle one)
Basketball Camp Recommended By________________________________________
Entire Fee Enclosed
(Fill in amount) $____________________
Please make checks payable to: ST. JOHN FISHER BASKETBALL
SCHOOL - 3690 East Avenue – Rochester, NY 14618
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It
is understood that the St. John Fisher College Basketball School
is not responsible for accidents resulting in medical, dental
or other expenses including loss of personal items. A non-refundable
$50.00 deposit for each applicant for each session is required
by June 1, 2012, with the balance due no or before the first day
of camp. A registration requires that a parent sign below to agree
that in case of an accident involving their son/daughter while
attending the St. John Fisher College Basketball Camp, they release
the school, the ownership, the coaching staff, the directors and
St. John Fisher College from all and any liability.
Parent's
Signature______________________________________________________________Date______________________
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