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2006 Fullcourt Press Inland Empire Invitational

PLAYER INFORMATION FORM

(please print)

Name_______________________________School_________________

Home Address_______________________________________________

City____________________________ZipCode____________________

Phone (    )_____________________email________________________

Grade 2006-2007____________Height________Weight_____________

Please mail $45 check (Make Checks Payable to “All West Camp”) and Completed Form to:  All West Camp, PO Box 77906, Corona CA 92877

Health and Behavior Guidelines and Waiver of Liability

Health Insurance Company_____________________________________

Policy No.___________________________Group No._______________

I understand that any Fullcourt Press Inland Empire Invitational (FPIEI) participant who does not abide by the rules, regulations and policies established by the FPIEI is subject to dismissal without reimbursement or recourse and I hereby waive and release the FPIEI and San Bernardino Valley College from any and all liability for any injury or illnesses while participating in the event.   I hereby authorize the directors of the FPIEI and San Bernardino Valley College to act accordingly to their best judgement in any emergency if I cannot be contacted.  I understand that each participant is required to have their own medical and accident insurance.  I also understand that the Fullcourt Press retains the rights to use for publicity and advertisement purposes, photographs of camp participants

Signature of Participant