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!