Warrior Strength & Conditioning Summer Camp 2023

Student's First Namerequired

Student's Last Namerequired

Gender*

Male Female

Date of Birthrequired

Student's Grade: August 2023required

School required

Home Phonerequired

Street addressrequired

Cityrequired

Staterequired

Ziprequired

Parent's First Namerequired

Parent's Last Namerequired

Daytime Phonerequired

Cell Phonerequired

Email Addressrequired

Emergency Contact Information

In the event of an emergency, Parents or guardians will be contacted first. Please list two alternate emergency contacts.

Emergency Contact 1required

Relationshiprequired

Daytime Phone #required

Cell Phone #required

Emergency Contact 2required

Relationshiprequired

Daytime Phone #required

Cell Phone #required

Medical Information

Physicianrequired

Phonerequired

Date of last DPT/tetanus immunizationrequired (mm/dd/yyyy)

In case of an emergency, I give my permission for the above named student to be given emergency treatment at any hospital reasonably accessible.

Health Concerns/Activity Restrictions

My child has the following health concerns (surgeries, diseases, etc.) or activity restrictions

Medication Administration

If the student takes prescription medication, please list

Allergiesrequired

My child is allergic to the following (foods, medications, insects, pollens, etc.). If none, enter "none".

Treatment for allergic reactions

Parent Agreement*

By checking the box below, I hereby certify my son or daughter is in good health and may participate in all activities. In case of an emergency, I hereby authorize my child to be given emergency treatment at a local hospital. As a parent or legal guardian, I authorize staff to have the above-named student examined by a qualified physician or dentist, and in the event of injury to administer any emergency care he deems necessary to ensure proper treatment. Every effort will be made to contact the parent or guardian to explain the nature of the problem prior to any involved treatment. In signing this form as a parent or guardian, I hereby agree to relieve the Camp and TWCA and/or its officers of any liability for injury or accident occurring on the premises, or athletic competition trip.

I agree

TWCA High School and Middle School Warrior Strength Memberships

TWCA Warrior Strength Membership*

High School Warrior Strength membership is $250.00 and Middle School is $200.00 for the whole summer.

High School Warrior Strength Membership Middle School Warrior Strength Membership

Total Due

Warrior Strength Membership Weeks, Days and Times

Week Options*

Select the weeks you would like to attend Warrior Strength. This will help our coaches know who to expect during the week.