MVP SPORTS CAMP P.O. BOX 2093 DARIEN, CT 06820 NAME______________________________________________________ ADDRESS___________________________________________________ CITY _________________________   STATE _____  ZIP  ___________ AGE_______  GRADE (sept 08)_______ School in Sept ________________________________ PHONE____________________________________ T-Shirt size (adult) _________ Contact Person ___________________________________Phone/cell ________________________ Emergency Contact _______________________________ Phone/cell ________________________ EMAIL ADDRESS ___________________________________________________________________ I hereby give permission for my daughter to attend and participate in the MVP SPORTS CAMP.  I hereby authorize the staff of MVP to act accordinly to their best judgement in any emergency requiring medical attention and that I hereby waive and release the MVP Sports Camp from any and all liabilities for any injuries/or illnesses incurred while at camp.  I have no knowledge of any physical impairment that would be affected by the registered camper's participation in the MVP Sport Camp program.  She has had a physical within the past year. Parent's Signature___________________________________________________________ Date ___________________ Allergies _________________________________________________ Asthma ___________________ Inhaler ________ Other ______________________________________________________________________________________________ Please make sure she has her inhaler with her at camp. CAMP SESSIONS Circle Weeks Attending   1      2      3      4 Week One  July 7-11  Basketball for Girls entering grades 3-9 Week Two  July 14-18  Basketball for Girls entering grades 7-12 Week Three July 21-25 Volleyball for Girls entering grades 5-12 Week Four July 28-August 1 Volleyball for Girls entering grades 8-12 The cost is $175 per week.  After June 15th cost is $190.00 Discount for campers coming all four weeks For more information contact Tom at 847-1899 or Mike at MikeSmeriglio@hotmail.com You can print this form and mail to the above address.