3rd, 4th 5th, 6th, 7th & 8th Grade PM Session

2021 3rd thru 8th PM Session Registration Form

12-2pm August 9th thru 13th @ Newtown Athletic Center

* Indicates required field

Player Name *

First

Last

Select PLAYER Grade for 2021-2022 *

Parent or Guardian Name *

First

Last

Parent or Guardian Email *

Any allergies OR concussions in the last 12 months? Please provide date of last concussion as applicable. *

EMERGENCY Contact Phone Number *

DISCLAIMER & PHOTO CONSENT
We understand accidents occur and players may become, develop or irritate [previous] injury while
participating in camp. Council Rock School District/supplemental sites are not held liable for these athletic incidentals
and your player is participating at their own risk. We will address any injuries brought to our
attention promptly and advise where possible. Over the course of camp, we may photograph and publish marketing materials containing our players, coaches and facilities.

I have read, acknowledge and agree to the Disclaimer and Photo Consent Policy *

yes!

2021 3rd thru 8th PM Session Registration Form12-2pm August 9th thru 13th @ Newtown Athletic Center​

2021 3rd thru 8th PM Session Registration Form

12-2pm August 9th thru 13th @ Newtown Athletic Center