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Registration

You can print the registration form and mail it in with your check. On line registration should be active by June 1.

REGISTRATION FORM

July 22-26 2019 8 AM to 12:30 PM

Please enclose your check for $115.00  ($130 after July 15) with your completed registration form.)

Mail to SSCCC 4405 N 19th St Tacoma, WA 98406

Register in person at any South Sound Running location prior to July 19, 2018

Name:    Age:   Gender:   M F          T-Shirt Size:     S   M  L   XL  

Street: City: Zip:

Phone (Day): Phone (Evening): Parent Email:

Grade (Next Fall) : 7   8   9   10   11   12   School: Coach:

Parent/Guardian Names Allergies or medical conditions (asthma, be stings etc.)

Emergency Contact: Emergency Phone:

I,_______________________________ (Parent/Guardian), hereby grant permission for my child, ________________, to attend the South Sound Cross Country Camp and verify that my child has received a physical examination in the past year and is physically capable to participate in activities, some of which are physically vigorous, related to the camp. I understand that participation in a running camp, despite all reasonable precautions implemented for my child’s safety, carries a risk of injury.  Consequently, I hereby, for myself, my child, heirs, executives and administrators, do waive and release any and all rights against all

persons given responsibility by the South Sound Cross Country Camp and Clover Park School District for the conduct of activities and rendering of services to my child in association with our participation. I hereby authorize the staff of the South Sound Cross Country Camp to act for me according to their best judgment in any emergency requiring medical attention and waive and release all involved from any and all liabilities for any injuries or illness incurred by my child during his/her involvement at this camp. I have no knowledge of any impairment that would limit or preclude my child’s involvement in any activities commonly associated with this type of instructional camp. I agree that costs for treatment of injuries or hospitalization for illness or injuries incurred during the camp will be the responsibility of the parent or guardian of the camp participant. I agree that any insurance carried by the parent or guardian may be used to defray such medical and hospital costs.

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