PLEASE PRINT OUT AND COMPLETE

Send registrations to:

LYNCH CAMPS
6001 W. 98th Street
Bloomington, MN 55438
612-347-8649


Participant’s Name______________________________

School Attending _______________________________

Birth Date____________ Age_____
Male____ Female_____

Address_____________________________________ City______________________ ZIP___________

Home Phone _____________________
Work Phone _____________________

E-mail address____________________________

Registering for -
Basketball:
___Little Shooters: Date______ Location__________________
___Full Week Camp: Date______ Location__________________

Tennis: Date_____Location__________

Soccer: Date_____Location__________

T-Shirt Size (Full Day Basketball only):
Youth: M_____ L______
Adult: S_____ M______ L_______

Where did you hear about us?
____ Family Times ____ Mpls. Star Tribune
____ Local brochure ____ Friend/referral
____Internet Search
____ Other________________________

Parent/Guardian Name(s)_________________________________________

Have You Previously Attended Our Clinic/Camp?________
If so, what location?___________________

MAKE CHECKS PAYABLE TO LYNCH CAMPS, INC.


Medical Release
I hereby grant permission to the Lynch Basketball/Tennis Camps to act for me according to their best judgement requiring medical attention, and hereby waive the Camp from any and all liability
for any injuries incurred while at camp.

____________________________________________
Parent or Guardian Signature


THANK YOU!