SMWS Summer 2017 Sports Camp RegistrationFor more information, contact: Mike Hawkes Email: mikeh@smwaldorf.org -------------------------------------------- Note About Payment: Upon submission of your registration form, you will get payment options. Your registration will not be processed until payment is received. Camper InformationFirst Name * Last Name * Grade Entering *6th7th8th Which camp(s)? *Check all that apply:Girls Basketball (June 12-16)Boys Basketball (June 19-23)Girls Volleyball (August 7-11) T-Shirt Size *Youth SmallYouth MediumYouth LargeAdult SmallAdult MediumAdult LargeAdult Extra-Large Medical Conditions/Allergies (if applicable) Parent InformationParent First Name * Parent Last Name * Address *Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountryAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepaNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabwe Phone * Email * Insurance Company Name * Insurance Policy Number * Parental Waiver AgreementParental Waiver Agreement In consideration of acceptance of this application for enrollment in the SMWS Middle School Athletic Camp, I waive and release any and all rights and claims for damages I may have against Shining Mountain Waldorf School. I hereby grant permission for my child to be a participant in the camp and if injury should occur during the camp I agree to pay all costs, present and future, through my medical insurance policy and/or personal finances. By checking this box I hereby give my child permission to participate and accept the waiver agreement. Any Other Questions? VerificationPlease enter any two digits with no spaces (Example: 12) *This box is for spam protection - please leave it blank
