2017 Dolphin Volleyball Camp Registration

____ June 19-23, 2017 - 1:00-4:00 Girls (ages 9-14) Volleyball Camp

Fee: $200.00 per week session

(payable to San Francisco Day School-SFDS)

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 San Francisco Day School-SFDS and send to:

Mary O'Brien c/o Dolphin Camps
350 Masonic Ave
San Francisco, CA 94118

Have fun, go Dolphins!

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