Kawartha Basketball Camp
Printable Parental Consent Form

     I, __________________________________ hereby certify that I am the parent or guardian of _______________________(the "Camper") who is applying to take part in the Kawartha Basketball Camp. I recognize the Camp activities will involve strenuous activity and certify that the Camper is fit to engage in activity of this sort. I recognize the risks that are inherent in the activities proposed for the Camp. In the case of an emergency involving the Camper, I understand that the Camp will make all reasonable attempts to contact me at the supplied telephone number. If the Camp is unable to contact me, I hereby authorize the Camp, or nurse/physician selected by the Camp, to hospitalize and/or secure proper treatment for the Camper.

I therefore give my approval to my child's participation in all activities of the Kawartha Basketball Camp and assume all risks and hazards incidental to such participation and do waive, release, indemnify and agree to hold harmless, other than for willful default or neglect on their part, Kawartha Basketball Camp, its volunteers and or employees.

(Initials) ____________

(Date) ____________

Please print this form, fill in the necessary information and send, along with your "Registration Form" and cheque made payable to     "Kawartha Basketball Camp" to:

Kawartha Basketball Camp
P.O. Box 2386
Peterborough, Ontario
K9J 7Y8