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Volunteer Sign-Up

Kansas City Basketball Sports Camp

Date: Saturday, May 1, 2010
Time: 9:45am - 12:00pm
Location: Swinney Recreation Center at UMKC
Volker Campus
5100 Rockhill Rd.
Kansas City, MO? 64110

9:45 - 10:00am

Registration & Check In
10:00 - 11:30am Skills Clinic
11:30 - 12:00pm Snacks & Giveaways

This free interactive camp allows kids with disabilities, either physical or developmental, ages 6-18 to experience first hand the sport of baseball. This fun-filled day will include instruction and skill development, use of equipment, games and prizes.

Sports Camp:
Participant First Name:
Participant Last Name:
Parent/Guardian Name:
Address:
City:
State:
Zip Code:
Phone:
Email Address:
Age:
Date of Birth:
Sex: Male
Female
Disabilities:
Seizures:

Yes
No

Medications:
Wheelchair:

Manual
Power

Emergency Contact:
Emergency Contact Phone:
 

Sports Camp Participant Waiver of Liability

In consideration of my child (participant) being permitted to participate in the Kansas City Basketball Sports Camp offered by the National Sports Center for the Disabled, University of Missouri – Kansas City and Kansas City Parks & Recreation Department, on behalf of my child, myself, and anyone who obtains rights from my child or me, I hereby voluntarily waive, fully release and discharge any of the above mentioned agencies and entities, their directors, officers, employees, agents, insurers, various sponsors and paid and non-paid volunteers from liability for injury, illness, death, damage or loss to participant or participant's property arising out of or in any way related to Participant's activities at the Kansas City Basketball Sports Camp.

I understand that the staff/volunteers of this camp are not allowed to administer medication or provide personal care such as feeding, toileting, and/or dressing. Anyone needing this type of assistance must make their own arrangements. I have read this form and understand its content and request registration for my child.

Agree: Yes
No
Photo Release
I grant permission for Participant's picture to be used in publicity or brochures related to this event.
Agree: Yes
No
Participant Name:
Parent/Guardian Signature:
Date:
Sign here: __________________________
Please print this page out and bring it to the camp with you.


P.O. Box 1290, Winter Park, Colorado 80482 USA ph: 970.726.1540 or 303.316.1540 fx: 970.726.4112
Denver Office: 1801 Bryant St, Ste 1500, Denver, CO 80204 ph: 303.293.5711 fx: 303.293.5448 Email:
info@nscd.org
KC Office: 4600 63rd St, Kansas City, MO 64130 ph: 816.513.7571 Email:
infokc@nscd.org

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