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Field Hockey Registration

(*) denotes required information.
A $25 deposit must be received by the field hockey camp office in order for this registration to be activated.
 
Camper Information:  
* First Name:
* Last Name:
* Phone:
* Date of Birth:
* Grade as of 09/08:
* Address:
* City:
* State:
* Zip:
* School:
* Experience in Field Hockey:
* Highest Level Played:
* Position:
 
Insurance Information:  
* Insurance Company:
* Policy Number:
* Phone Number:
Address:
City:
State:
Zip:
 
Emergency Contact Information:  
In the event of an emergency, please list two people we can contact:
* Primary Contact:
* Relationship to Camper:
* Phone:
Contact:
Relationship to Camper:
Phone:
 
Medical Consent:  
I hereby authorize a representative of Gettysburg College Field Hockey Camp to take my child to a physician or hospital, should the need arise. I also understand that my insurance is primary if medical attention is required.
* Camper's Name:
* Signature of Parent/Guardian:
 
 
Gettysburg College 300 North Washington Street · Gettysburg, PA 17325
P: 717.337.6300
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