____ June 16-20 - 9:00am - 12:00 pm Girls (ages 9-13) Basketball Camp
____ June 16-20 - 1:00-4:00 Girls (ages 9-13) Volleyball Camp
____ June 23-27 9:00am - 12:00 pm Girls and Boys Soccer Camp grades K-5
Cost: $185.00 per session
Name: _______________________________________________________________________________
Phone_____________________________
Address:____________________________City/Zip: _____________________
Age: ______ DOB:________ Grade: ________ School: ___________________
Playing Experience:__________________________________________________
Please note any medical condition:_____________________________________________________
Insurance Company:______________________Policy # ____________________
Doctor's Name and #:_________________________________________________
Emergency Contact:___________________________________________________
I hereby authorize the staff at Dolphin Camps to act for me
according to their best judgment in any emergency requiring medical
attention and hereby waive and release the Dolphin Camps from any
injuries or illness while at camp. The camp staff has my permission to
seek any emergency treatment necessary for my child while in attendance at
the camp named above.
Parent/Guardian Signature: _____________________________________Date:_________________
for Dolphin Camps print this form and make check payable to SF Day/Dolphin Camps and send to:
Mary O'Brien c/o Dolphin Camps 350 Masonic Ave San Francisco, CA 94118Have fun, go Dolphins!