Camp Registration

As the parent or legal guardian of the below-named player, I hereby give consent for emergency care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well being of my dependent. This registration serves as a signature to this waiver.

Mandatory *

First Name *

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Last Name *

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Camp Attending *

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Date Attending *

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Date of Birth * Please follow the default format- Month/Day/Year

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Phone Number * Please include phone number without using any spaces or other characters

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Street Address *

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City/Town *

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Zip Code *

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Emergency Contact Name *

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Emergency Contact Phone *

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Atlantic Sports Group

League