Otteson Razzle Dazzle Challenge Camp Application Form

Player's information list:

First Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
Home Phone
E-mail

I hereby authorize the staff of the Otteson Razzle Dazzle Challenge Camp to act for me according to their best judgment in any emergency requiring medical attention, and I hereby waive and release the camp from any and all liability for any injuries that incurred while at the camp.  I have no knowledge of any physical impairment that would be affected by the above names participating in this camp.

                    
                Parent or Guardian                                     Date

Insert Comments or Concerns