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951-805-1353
Meeting at: California Lutheran High School
31970 Wildomar Trail
Wildomar, CA  92595
Path to Victory Registration
Child's Name:*
Sex:*
Address:*
Parents' Names:*
Home Phone:*
Cell Phone(s)*
Work Phone(s)*
Email Address:*
Other Emergency Phone & Name:*
Special Medical Conditions:*
Grade (Fall '13):*
T-Shirt Size:*
Do you regularly attend a church?*
 Yes
 No
If yes, where? If no, please type "NONE".*
PERMISSION: The child listed above desires to participate in the basketball camp from June 24 - 26, 2013 located on the property of California Lutheran High School for the sum of $20.00. The undersigned parent/guardian acknowledges that there are dangers and risks of injury inherent in sports activities, but still allows his/her child to participate in said activities. Permission is also granted to Living Hope to any photos/videos of the participant for promotional purposes. Therefore, the undersigned, for and in consideration of the opportunity to participate in the Path to Victory Basketball Camp and for other good and valuable consideration, does hereby accept full responsibility for liability and cost of treatment of injury to the above registered person. The undersigned does hereby release the teachers/coaches/assistants, Living Hope Lutheran Church, and California Lutheran High School from all liability resulting from negligence and agrees to hold them harmless for any injuries and/or damages his/her child may sustain arising out of the activities inherent in a basketball camp. The undersigned further declares and represents that no promise, inducement or agreement not herein expressed has been made to the undersigned, and that this release contains the entire agreement between the parties hereto, and that the terms of this release are contractual in nature and are not a mere recital. Parent's Signature:____________________________ Date:____________________________ PLEASE COMPLETE YOUR CHILD'S REGISTRATION BY SENDING YOUR $20.00 CHECK TO: Living Hope, PO BOX 94, Wildomar, CA 92595*


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