Cougar Basketball Camp 2019

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Cougar Camp Registration 2019
-Please print a copy and mail back-

Name of Camper ________________  Age_____ Gender____ Grade Going Into_________
Name of Camper _________________ Age_____ Gender___ Grade Going Into_________
Name of Camper _________________ Age_____ Gender___ Grade Going Into_________

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Cougar Camp is $185 per person, only $170 for the 2nd / 3rd sibling.
If you attend 2 weeks of camp, total cost $355 per person, all 3 weeks total cost is $510
Please circle which week(s) of camp your son / daughter will attend:

Week #1:  July 8-12
  Week #2:  July 15-19

Week #3:    Aug 5-9

Parent Name__________________________
Email Address_________________________
Home Address_________________________
City_____________ State ____ Zip________
Home (____)__________________________
Work (____)__________________________
Insurance Company____________________
Policy #_____________ Group#___________
Medical Release Statement
My son/daughter is in good physical
health & he/she is able to participate in
various camp activities. I give permission
to coaches and athletic trainers to use
their best judgment when dealing with
injuries or other medical issues related to
my son/daughter.

Parent Signature_______________________

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Checks Payable to: Cougar Camp
PO Box 671 New London, NH 03257       or    Venmo: CoachCamp3