Registration Form

                                    NKD Basketball Camps

  Camper’s Name_________________________________________



  __________________________ Postal Code__________________

  Telephone_______________ MCP No.______________________

  School Attending________________________________________


  E-mail address:_____________________________________________

  NKD Basketball Camp Waiver

  In case of emergency please contact:

  _____________________________Telephone #_______________

  In the event of inability to contact me, I hereby consent to medical examination   

  and/or treatment by members of the medical/dental staff of any Newfoundland

  hospital to my child while attending NKD basketball camps.

  To be signed by parent or guardian:

  Although it is understood that the staff will endeavor to provide the maximum 

  supervision possible, NKD Basketball are in no way responsible for injuries to my

  child or loss of property.

  I hereby consent for my child to participate in all activities listed.


  Parent/Guardian                                     Date

  HST No.  74927 5897 RT0001