A.C.A.M.P Adrenaline Coaching and Mind Prep

A.C.A.M.P. Registration Form

310.570.7672

Registration

Returning player:

YES

Referred by:

Your Email:

Athlete’s Name:

Gender : Male Female

Date of Birth :

Address:

City:

Zip:

Grade:

Home Phone:

School:

Height:

Weight:

Years Experience w/Sports Teams any kind :

Sports/Activities your Child is Interested In:

T-Shirt:

YM YL M L
AS AM AL XL

Parent Name: (first & last name)

Cell Phone:

Authorized Pick-Up Names:

Parent/Player Special Requests
or To Be Aware Of:

MEDICAL INFORMATION

Family Physician Name

Office Telephone

Street Address

City

Zip Code

RELEASE OF LIABILITY
Any and all risks assumed by participating in A.C.A.M.P. shall be undertaken by said participant or the participant’s legal guardian. A.C.A.M.P shall not be held liable for any claims demands, injuries, or cause of action to person or property connected with the use of services or facilities affiliated with A.C.A.M.P its employees or agents. In the event of injury, I authorize A.C.A.M.P and its medical aid staff to obtain and/or administer any treatment or medical care deemed necessary. I HAVE CAREFULL Y READ THIS AGREEMENT/RELEASE AND FULLY UNDERSTAND ITS CONTENTS. I ACKNOWLEDGE AND UNDERSTAND THAT, BY THIS AGREEMENT, I AGREE TO ASSUME ALL RISKS OF A.C.A.M.P., AND IN THE EVENT OF MY CHILD’S ILLNESS OR INJURY, I WILL HAVE NO RECOURSE AGAINST A.C.A.M.P, IT’S AGENTS OR EMPLOYEES.

I Agree to Terms Above .

Please indicate what Summer Sports Programs you are registering for:

Total Payment for Summer Sports Program:

Indicate here if you are interested in Private Coaching:

Summer Camps Registration Coming Soon We accept registration by mail or online. Send check payment to:	A.C.A.M.P. 736 Gould Ave, Unit 11 Hermosa Beach, CA 90254
Make checks payable to A.C.A.M.P. and please include child's full name on the memo line. Discounts do apply for families who sign up more than one child (sibling) for ACAMP.

Make checks payable to A.C.A.M.P. and please include child’s full name on the memo line.

Registration Policies
Full payment is required at time of registration.
Registration is not guaranteed until confirmed by an A.C.A.M.P. staff member.
(A staff member will contact you within 24 hours.)

No refunds will be granted after commencement of camp.
Returned checks subject to $15 fee and $15 processing fee for all refunds.

Cancellations
A.C.A.M.P. reserves the right to cancel this camp due to low enrollment or unforeseen
circumstances. Refunds will be issued in 3-4 weeks.

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