South Lakes High School 2011 Volleyball Camp

Monday Friday, June 27 July 1, 2011 5:00 pm to 9:00 pm South Lakes HS Gym Boys and Girls Ages 11 to 17 years old Sign up early Space is limited! Cost - $100 per camper / $90 for each additional camper (in the same family) Staff - The camp will be conducted by members of the South Lakes HS Coaching Staff and Varsity Student Athletes Additional Information: o Each Camper will receive a free camp T-shirt! o Campers will bring their own food for dinner. o Pizza, snacks and drinks will be available for sale. Register online at www.SeahawkBoosters.com or by mail to South Lakes Athletic Booster Club Attn: SLHS Volleyball Camp 11400 South Lakes Drive Reston, VA 20191 Return bottom of form with full payment (one form per camper) 2011 SLHS Volleyball Camp Application Form Campers Name Age Grade in Fall 2011 Address City, State Zip Home Phone Parent Email Address Emergency Contact Name / Phone T-shirt Size (circle one) Adult S M L T-shirt Sizes * Camp registration refunds will not be issued after June 1, 2011 Medical Consent

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I hereby state that my child is in good health, and has my permission to participate in all activities. In addition, I authorize the South Lakes High School Volleyball Camp staff to act for me in securing medical treatment for my child in the event of injury or illness. A registration requires that a parent or guardian sign below to agree that in case of an accident involving my child while attending the camp, they release the camp, school, sponsors, booster club, counselors and directors from any and all liability.

Parent / Guardian Signature

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