BECAUSE SPACE IS LIMITED!!!

Name________________________________ School _________________________________

Home Address ________________________________________________________________

City ___________________________________________ Zip Code ______________________

Phone (       ) ____________________________ e-mail _______________________________

Grade 2009-10 ________________ Height ___________ Weight _________

GPA __________________ SAT/ACT Score _________________________

Parent/Guardian _______________________________________________

Please Circle One:        Day Camper $225         Overnight Camper $275

Please mail payment (make money orders payable to “All-West Camp”) and completed form to:

FCP All-Frosh/Soph Camp, P.O. Box 77906, Corona CA 92877

HEALTH AND BEHAVIOR GUIDELINES AND WAIVER OF LIABILITY

HEALTH INSURANCE CO. ______________________________________________________

Policy No. _____________________________________ Group No. _____________________

I understand that any Fullcourt Press All-Frosh/Soph Camp participant who does not abide by the rules, regulations and policies established by the Fullcourt Press All-Frosh/Soph Camp (FPAF/SC) is subject to dismissal without reimbursement or recourse and I hereby waive and release the FPAF/SC and the Lynwood High School (LHS) from any and all liability for any injury or illnesses while participating in the camp.  I hereby authorize the directors of the FPAF/SC and LHS to act according to their best judgment in any emergency if I cannot be contacted.  I understand that each camp participant is required to have their own medical and accident insurance.  I also understand that the FPAF/SC retains the rights to use for publicity and advertisements purposes, photographs of camp participants.

SIGNATURE OF PARENT OR GUARDIAN

www.fullctpress.net