Burnet High School

Basketball (M)

Bulldog Basketball Camp - Session 1 - incoming 3rd grade through incoming 6th

Camp Start Date:

June 6, 2022

Start Time:

8:30:00 AM

Camp End Date:

June 8, 2022

End Time:

11:30:00 AM

Venue Name:

Main Gym

Venue Address:

1000 The Green Mile, Burnet, TX 78611

Camp Cost:

$50.00

Questions:

Roy Kiser

rkiser@burnetcisd.net

(512) 756 - 4501

Medical Info:

I hereby release Burnet CISD including without limitation, its directors and employees, from and against any and all liability, injury sustained, damage to, or loss of personal property arising directly or indirectly while enrolled in the Bulldog Basketball Camp.

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Bulldog Basketball Camp - Session 1 - incoming 3rd grade through incoming 6th

First Name *
Last Name *
Mobile *
Email *
Grade (2022-2023 school year) *
Birth Date *
Select t-shirt size *
Address *
City *
State *
Zip Code *
Medical Information *

List Medications/Medical Conditions here. If none, type N/A

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Guardian First Name *
Guardian Last Name *
Guardian Cell Phone *
Guardian Email *
Alternate Guardian First Name
Alternate Guardian Last Name
Alternate Guardian Phone
Alternate Guardian Email
Medical Release Information
I hereby release Burnet CISD including without limitation, its directors and employees, from and against any and all liability, injury sustained, damage to, or loss of personal property arising directly or indirectly while enrolled in the Bulldog Basketball Camp.
Guardian Signature *

I, the parent/legal guardian, agree entirely to the Medical Release Information.: clear

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Burnet High School Basketball (M)

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Bulldog Basketball Camp - Session 1 - incoming 3rd grade through incoming 6th

CAMPER INFORMATION

PARENT/GUARDIAN INFORMATION