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2003 Cobber Boys Cage Camp Online Registration Form

Please Print and Send to:
Cobber Boys Cage Camps, Concordia College, 901 South Eighth St., Moorhead, MN 56562

PLEASE PRINT CLEARLY
 

_________________________________________________________________________________
Last Name                         First                                           email

_________________________________________________________________________________
Address                                                  City                       St                          Zip

__________________________________________________________________________________
Phone                   t-shirt size (adult)                      Grade in 2003-4         Age              Height

__________________________________________________________________________________
Parent's Name(s)                                                              Team Played On

__________________________________________________________________________________
School                                           Coach                                           Roommate
 

I hereby request that you accept the enrollment of ___________________________________in the 2003 Basketball Camp.  I hereby release the Cobber Basketball Camp Staff, Concordia College and all their employees and agents from all claims on account of any injuries which may be sustained by my daughter while attending the camp, and any claims hereafter which may be presented by my daughter while attending this camp, and any claims which hereafter may be presented by my minor daughter as a result of any such injuries.   I also certify that she is medically fit to participate in this camp.

___________________________   ___________________________________
Parent's name (print)                      Parent's signature
 

________________________________________________________________
Work phone                                        Home phone
Each camper is responsible for her own insurance.

Camp Session(s).
Please check the camp(s) you are entering.

______Cobber Boys Camp - Grades 4-6, 7-9, 10-12 (June 16-20)

______Varsity Team Camp - Grades 9-12 (June 21-22) (Please send in all registrations as a team)

______Jr. High Team Camp - Grades 6-8 (June 23-25)

Camp Accommodations -  Please check one.

_____Resident Camper (all services) ______Board (meals but no room)   _____Instruction only

 A non-refundable fee of $50 is required to hold your spot in this camp.  The balance is due at registration. Please make checks payable to Cobber Cage Camp.
Send to: Cobber Boys Cage Camps, Concordia College, 901 South Eighth St., Moorhead, MN 56562
 

Camp Director - Duane Siverson
Call 218-299-4160 or email: dsiverso@cord.edu
 



This page is maintained by the Concordia Sports Information Office sid@cord.edu
 

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