Apex Youth Camp Registration: July 25th - July 28th, 2011

Registration is a two step process. Fill out the registration form below. After you hit submit, you will be forwarded to another page that you can print for your records. Print that page and then click the link at the bottom of that page to continue. This will allow you to finish the second step which is your online payment provided by Google Checkout.

Wrestler Information First Name Last Name Street City St Zip AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Email Address Phone Number Grade --- 1 2 3 4 5 6 7 8 Weight T-Shirt Size --- YS YM YL AS AM AL AXL AXXL School Insurance Policy Allergy/Medications     Camp Selection --- Wrestling Only - Morning at Pittsford - $75.00 Wrestling Only - Afternoon at HFL - $75.00 Wrestling Morning and Lacrosse Afternoon - at Pittsford - $150.00 Football Morning and Wrestling Afternoon - at HFL - $130.00     Waiver *Neither Pittsford Lacrosse or Apex Wrestling or Apex Wrestling nor their staffs assume responsibility for accidents or medical expenses incurred as a result of participation. All athletes must assume responsibility for any medical expenses incurred. I have adequate medical coverage and insurance and give my child permission to attend the Apex Wrestling Youth Camp and or Pittsford Youth Lacrosse Camp and or Apex Football Camp and I agree to indemnify Apex Wrestling and Pittsford Lacrosse and Apex Football and its employees for any claim which may hereafter be presented by my child as a result of any such injuries.   Yes, I as Parent/Legal Guardian Accept the Risk No, I as Parent/Legal Guardian I do not Accept the Risk   Payment Information Name of Person Paying NOTE: This information will identify payment for this registration. Please type the Google Checkout account holder. If you do not have a free Google Checkout account, then enter the name on the credit/debit card of the person that is paying. Other Comments None.