2010 sports camp brochure for Lausanne Collegiate School in Memphis, TN

1. Please print information clearly. Mail registration form with
payment to Lausanne Camps, Lausanne Athletic Dept, 1381
West Massey Rd, Memphis, TN 38120, payable to Lausanne
Collegiate School OR register online at www.lausanneschool.
com or www.camppros.com. All major credit cards will be ac-
l
cepted online. You are advised to register early as there are
iate Schoo
limited spots available. Players must check in at 8:30.
Lausanne Colleg
Boys Basketball (Elementary) Girls Basketball
Boys Basketball (Middle School) Lacrosse
Football Tennis Soccer
Name: Age: Birth date: / /
Wt: Ht: School: Gr: M F
Shirt Size: Youth Adult S M L XL XXL XXXL
Parent/Guardian:
Mailing Address:
City: State: Zip:
Home Ph: Work Ph:
Cell Ph: E-mail:
Physical Restrictions/Disabilities:
Curious. Confident. Courageous.
Physician’s Name: Phone:
Insurance Company:
We are Lausanne.
Policy Number:
Did your child participate in Lausanne camps last year? Y N
REGISTRATION AGREEMENT AND WAIVER:
In consideration of being allowed to participate in the Lausanne sports camps, related
events and activities, the undersigned agrees to indemnify and hold harmless Lausanne
Collegiate School, and grant full permission to presenters of this program to use any photo,
videotape, DVD recording or any other record of events for any purpose.
Agree that participant should inspect the facilities and equipment to be used, and if the
participant believes anything is unsafe, he/she should immediately advise the coach or the
supervisor of such condition(s) and refuse to participate.
Acknowledge and fully understand participants will be engaging in activities that involve
risk of serious injury, including permanent disability and death; and also severe social and
economic losses which might result not only from their own actions, inactions or negligence,
but the actions, inactions or negligence of others; or the condition of the premises or of any
equipment used. Further, that there may be other risks not known to us or not reasonably
foreseeable at this time.
Assume all the foregoing risks and accept personal responsibility for the damages following
such injury, permanent disability or death.
Release, waive and discharge and covenant not to sue or pursue legal action against Lau-
sanne sports camps, its affiliated clubs, respective administrators, directors, agents and/or
other employees of the organization, other members/participants, sponsoring agencies and
sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct
events; all of which are hereinafter referred to as “releases,” from any and all liability to each
of the undersigned, his/her heirs and next of kin for any and all claims, demands, losses or
damages on account of injury, including death and damage to property, caused or alleged to
be caused in whole or part by the negligence of the releases or otherwise.
Parent/Guardian signature below attests to your agreement to adhere to all of the rules and
regulations of the facilities that events are held in, and that you have read this registration
form and grant full permission for your child to participate in the Lausanne Collegiate School
sports camps.
Parent/Guardian Signature: Date: / /

2. -4
...... June 1
..................
.................. -11
Football...... ..................
....... June 7
tball........ -11
Girls Baske ..................
...... June 7
................ -18
Lacrosse.... dle School)
.... June 14
etball (Mid e 21-25
Boys Bask ta ry)......... Jun
all (Elemen ne 21-25
B oys Basketb ...... .............. Ju
.................. July 12-16
Tennis........ ...... .................
..................
Soccer......
ill be at 8:30
*Check-in w
Cost to Participate
Elementary
K-4 ..............
Middle Sch ........... $125/p
ool 5-8 ........ erson
............ $125
Register on
line /person
at laus
or at camp anneschool.com
pros.com
Location
Lausanne C
olle
1381 West giate School
M
Memphis, T assey Rd
N 38120
For More In
formation:
C
or E-mail a all (901) 474-1050
thletics@la
us a n n e s c h
ool.com
Register online at www.lausanneschool.com or www.camppros.com