Pine Acres Sports camp 2010 is an incredible Sports Camp experience for boys and girls who are finishing 1st through 5th grades. Each day includes solid athletic training from coaches and athletes, as well as dynamic Bible training and lots of fun! There will be classes in basketball for both boys and girls and Cheerleading for girls. Pine Acres Sports Camp will be held
June 1-4 (Tuesday through Friday)
9:00 am – 11:45 am
At SWOSU Wellness Center
Cost: $25 per person (includes a camp t-shirt)
Please fill out the bottom portion of this form and return it with your payment of $25 to Pine Acres Church, 1321 Lark Street, Weatherford, OK 73096 by Wednesday, May 26th, to reserve your child’s spot. Enrollment is limited. For information call 772-2190.
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Child’s Name: __________________ Parent’s Name: ______________________
Address: _____________________ Phone: _____________ Cell:____________
_____________________ Age: ______________ Grade: __________
Sex: c Male c Female Sport: Basketball: c Cheerleading c
T-Shirt Size: c Child S c M c L c Adult S c M c L c XL
I, the undersigned parent or guardian of ____________, do hereby authorize any duly authorized representative of Pine Acres Church, as agents for the undersigned, to consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment, and hospital care which is deemed advisable by any licensed physician, dentist, or surgeon in the specific case that parents or legal guardians cannot be contacted to provide consent. This authorization is given in advance of any specific care being required. I also do hereby give permission for said minor to participate in all Pine Acres Sports Camp activities. This authorization shall remain effective from June 1-4, 2010.
Signed ______________________________________________
