Summer Athletic Camp Payment - Mater Dei Catholic Online Store

ATHLETE INFORMATION

Name*

Email Address*

Where will you attend school during the 2023/24 school year?*

Mater Dei Catholic High School
Other

School Name*

Date of Birth*

PARENT INFORMATION

Name*

Prefix First Last

Email*

Enter Email Confirm Email

Address*

Phone*

Medical Insurance Company*

Medical Insurance Number*

CIF Disclaimer

Any student-athlete, who has pre-enrollment contact with a coach or anyone affiliated with a high school program and subsequently transfers to or enrolls at that school, may be declared to be athletically ineligible to compete in interscholastic athletics. Both the student-athlete and the coach/person affiliated with program must disclose all pre-enrollment contact to the CIFSDS office.

Medical Emergency Release*

I hereby authorize Mater Dei Catholic Directors to act for my according to their best judgement in any emergency requiring medical attention and I hereby waive and release Mater Dei Catholic from any liability for any injuries or illnesses incurred by my child while at Mater Dei Catholic.

CIF Disclaimer Acknowledgement*

I acknowledge that I have read and fully understand the CIF Disclaimer written above.

Marketing Release*

I grant Mater Dei Catholic Directors and employees the right to take photographs of participants in connection with marketing materials. I hereby relinquish any right that I may have to examine or approve the completed product(s) or the advertising copy or printed matter that may be used in conjunction therewith or the use to which it may be applied.

Signature*

Date*

MDCHS Summer Athletic Camps

Step 1 of 3

SUMMER ATHLETIC CAMP SELECTION

CAMP INFORMATION

CART

TOTAL

ATHLETE INFORMATION

PARENT INFORMATION

TOTAL

PAYMENT INFORMATION