1. RHARE BREED TRAINING
SUMMER READY CAMPREGISTRATION FORM
JULY 9 – AUGUST 8
PERSONALINFORMATION
Name: Birthday:
Last First Middle Initial (mm/dd/yyyy)
Email address:
CONTACT INFORMATION
Address: Cell Phone:
CA HomePhon
e:
City State Zip code
EMERGENCY CONTACT INFORMATION IF under 18
Parent Name:
Relation: Ph.
Ph.
Parent Name:
Relation:
MEDICAL CONDITIONS
Please list any conditions that may be a concern to participate in this Camp, include any medications:
*** CONSENT FOR EMERGENCY TREATMENT AND RELEASE OF LIABILITY***
I understand that there are always risks involved in sports activities. I acknowledge these risks and declare my child physically able to
participate in the Rhare Breed Training program. In the event of a medical emergency, I authorize any Rhare Breed Training
representative to obtain emergency treatment for my child, (if my emergency contact cannot be reached). I understand the costs of
medical treatment are my responsibility and that a relative of the player must be at the hospital to assure proper medical treatment. I
agree to abide by the rules and regulations, as may be established by Rhare Breed Training. I, intending to be legally bound, do waive
and release all rights, claims, demands, and/or causes of action against Rhare Breed Training, its partners, associates, and sponsors for
any personal injuries suffered which may occur, now or in the future, arising from or out of my participation with Rhare Breed
Training. I acknowledge that all videos, photographs and/or likeness taken by Rhare Breed Training, its owners, officers, employees,
successors, assignors and anyone acting under the authority or permission thereof, to make and copyright photographs and video
("Photographs and "video" as used herein include any reproductions of my likeness, voice, name and/or image) can and will be used
and distributed for promotional purposes.
Insurance Provider: ID#:
REGISTRATION COSTS
Registration fee: $150 *Cash, Money order or
Major Credit Card
$10 off each friend
who joins
Name (Print) Signature Date
Ph. (909)276-4131 Fax. (909)980-7908

2. RHARE BREED TRAINING
SUMMER READY CAMPREGISTRATION FORM
JULY 9 – AUGUST 8
Ph. (909)276-4131 Fax. (909)980-7908