1. Clinic Information Girls grades 9 th - 12 th Dates: May 27 – July 18 (Monday, Wednesday, Friday) Times: 2 ½ hours per day (schedule to follow) Location: CCA Gym Clinic Fee: $300 (make checks payable to CCA Foundation) Varsity, JV teams will be participating in weekend tournaments throughout the summer. Clinic Fee Includes: Professional Instruction State of the art facility Clinic T-shirt ================================================================================================================== Registration Form: Campers Name:_____________________________________________Age: ______Grade:______ Address, City, Zip:_________________________________________________________________ Home#_________________Cell#_________________________Emergency#__________________ Permission to Participate; Release, Waiver of Liability, and Indemnity Agreement I/we give permission for ________________________________ (name of child/youth) to participate in the above activities, In consideration of the opportunity of my/our child/youth to participate in the activities of CCA Foundation I/we release CCA,Foundation its officers, agents, employees, staff, and volunteers from any and all liability of any kind whatsoever for any loss or injury to my/our child/youth arising from my/our child/youth's participation in the activities of CCA Foundation; and I/we agree to indemnify and hold forever harmless the CCA Foundation, its officers, agents, employees, staff, and volunteers from any and all liability of any kind whatsoever for loss or injury to my/our child/youth arising from activities on or off the premises of CCA Foundation. I/we understand and agree that this permission and agreement shall remain in effect until revoked in writing by me/us, and I/we understand and agree that it is my/our responsibility to update our child/youth's medical and insurance information as changes occur. Photo Permission. I/we understand that my child may be photographed while participating in the activities of CCA. I/we (do) or (do not) give permission for a recognizable image of my child to be posted on the CCA website or bulletin boards. I understand that a non-recognizable image, such as a group picture, may be posted. In the event of a sudden illness, accident or injury which may occur while said minor is engaged in activity supervised by the CCA Foundation, when neither the parents, guardian or family physician can be contacted, I hereby give my consent for emergency treatment as shall be necessary and release and discharge the CCA Foundation on all claims for personal injury. I CERTIFY THAT I HAVE PERSONALLY READ AND UNDERSTAND THIS WAIVER AND RELEASE FORM Parent Print Name:________________________________ Signature:________________________________________Date:_____________ Email address:________________________________ Medical History:___________________________________________ Parent Print Name:_________________________________Signature:_______________________________________Date:_____________ Email address:________________________________ Medical History:____________________________________________ Mail registration forms to CCA Girls’ Basketball ~ 5951 Village Center Loop Rd, San Diego, CA 92130 For more registration information email scott@swm-co.com The Raven High School Girls Basketball Clinic is for players who are interested in being part of the girls’ basketball program next season. Scott Tucker, head Varsity coach at Canyon Crest Academy, along with other Canyon Crest Academy coaches will stress team and player development.