CFBISD Softball Camp Information
8401 E. Valley Ranch Parkway Irving, Texas 75063 A.M. Session – 1st – 4th Grade 8:30 am – 11:30 am P.M. Session – 5th – 9th Grade 1:00 pm – 4:00 pm Grades based on 2007-2008 School Year Register @ Gate will be held from 8:00am to 9:00 am on Monday, June 4, 2007. Bats Gloves Batting Helmets Catcher’s Gear (if a catcher) Ball Cleats Sun Screen Visor Knee Pads (for sliding) Cool Clothing including sliders WATER!!!!! 2007 C-FBISD Softball Camp Registration Form Complete the registration and release forms and mail it (or drop it by RLT) with your cash, money order, or cashiers check to: C-FBISD 1600 S. Josey Lane Carrollton, Texas 75006 Parent/Guardian’s Name: _________________________________________ Address: ___________________________________________________________ City: ______________ State: ________ Zip: _______Home Phone: __________________ Cell Phone: __________________Age: _____ Grade: ____ HT: ___’____" WT: ____lbs. E-mail Address: _________________ ___________________________ Camper’s Name_________________________ Camper’s SSN________-_____-________ Parents In accordance with the rules of C-FBISD Softball Camp, I hereby give my consent for my child to participate in any and all camp activities. If at any time it is necessary for the aforementioned camper to receive services from an off-campus medical or physical facility, the camp will secure transportation as is deemed necessary. I will not hold the camp responsible for any benefits beyond the camp medical insurance program and will secure any benefits beyond the camp medical insurance program and will secure adequate family insurance coverage is additional protection is desired. Insurance Company: _____________________________________________________________ Parent / Guardian Signature Date Recognition & Assumption of Risk Agreement I, the understand parent/guardian of __________________________________ Authorize said child’s participation in the C-FBISD Softball Camp I hereby agree that I will not hold Renee Putter, her staff, the Carrollton/Farmers Branch School District, or it’s employee’s responsible for any loss, damages or personal injuries that he./she may receive as a result of participation. This waiver of liability expressly includes camp activities, or while in or upon the premises whereby activity is being conducted. I also agree to follow all instructions and procedures in order to maintain a maximum level of safety, and that I should make sure my child is covered with adequate insurance in the event of serious accident. I also give my permission for any emergency medical care or treatment by a physician, surgeon, hospital, or medical care facility that may be required and accept the responsibility for the cost. This form must be filled out and returned with the application. ________________________________________________________ Parent/Guardian Signature Date Medical Information C-FBISD strongly recommends a pre-camp physical for every participant, especially for those who are not yet required to have a yearly physical for athletic participation by the public schools. This alerts the camp staff of any particular medical problems and could prove to be a valuable asset should the need for medical attention arise. Questionnaire Allergies: ________________________________________________________ Hay Fever: ____________________ Hernia: ____________________ Sensitivity to drugs or medication: _______________________________ Name of Medication: __________________________________________________ Eye Problems: _______________________________________________________ Ear Problems: _______________________________________________________ Asthma or Lung Problems: __________________________________________________ Heart Trouble: _________________________________________________________ Chronic Skin Problems: _____________________________________________________ Kidney or Urinary Problems: _________________________________________________ Medication Taken Regularly: _________________________________________________ Broken Bones: Y / N What: _____________ When: _______________________________ Previous Medical Problems: __________________________________________________ Describe any serious injuries: _________________________________________________ If, in the judgment of any representative of the C-FBISD Softball Camp, this participant should need immediate medical care and treatment as a result of injury or sickness, I do hereby request, authorize and consent to such care and treatment of said participant. It is also understood that all medical expenses incurred will be the responsibility of the undersigned and not the C-FBISD Softball Camp. ____________________________________________ Parent/Guardian Signature Date Return From CFBISD Softball Camp to Softball Camp Home
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