Camper’s
Name
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Age |
Date of Birth |
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Parents’ Names |
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Mailing Address |
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Shirt size |
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Town |
Zip |
Gender |
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Home Phone |
E-mail |
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Dad’s work # |
Mom’s work # |
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Cell Phone #’s |
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Will need shuttle transportation: to______
from _______ |
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Please select the week(s) you wish to
attend:
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(1) June 25-30 |
(2) July 15-21 |
(3) July 23-28 |
(4) July 30-August 4 |
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General level of play (for your age): |
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Advanced |
Intermediate |
Beginner |
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2 to 4 aspects of your game you would like to
improve: |
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Years playing squash |
Do you compete? |
Ranking(s) |
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School |
Grade finished as of this summer
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Weight Height |
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Payment included with entry form (please mark): |
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Full - Boarder ($975.00) ** |
Deposit *- Boarder ($400.00) |
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Full - Non Boarder ($725.00) ** |
Deposit * - Non Boarder ($300.00) |
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Additional night (s) between sessions - please specify
($100.00 per night) |
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Shuttle to and/or from |
Roommate request – |
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Flight information |
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*
Deposits are non refundable. ** Full
payment is due 2 weeks prior to the start of camp and is not refundable if
cancellation is made within 2 weeks from the start of camp, unless a new participant
can take the vacated spot. |
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Health Insurance Carrier
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Policy # or ID # |
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Name of Insured |
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Medical Issues |
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PARENTAL PERMISSION AND LIABILITY WAIVER |
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I hereby release, waive, discharge and covenant
not to sue the Fortson Squash Camps, Bowdoin College, their respective
administrators, directors, agents, coaches, and other employees or
participants in the Fortson Squash Camps, from demands, losses or damages on
account of injury or damage to property, caused or alleged to be caused in
whole or in part by my son/daughter’s participation in, or attendance at the
Fortson Squash Camps. |
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Parent/guardian
(name, signature, date) |
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PLEASE MAKE CHECKS PAYABLE TO FORTSON SQUASH
CAMPS, L.L.C. AND MAIL TO:
TOMAS FORTSON,
9000 COLLEGE STATION,