Roosevelt Boys Basketball Camp 2022

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Event Timing: July 12, 13, 14, 15 from 9AM-3PM

Age: Incoming 4th, 5th, 6th, 7th, 8th and 9th grades

Location: Roosevelt High School Gym

What to bring: Water bottle, snacks and sacked lunch

Cost: $300 (Checks payable to Roosevelt Booster Club c/o Boys basketball)
Scholarship cost: $75

Pay by SPS School Pay (note grades are incorrect on school pay 4th-9th)

https://schoolpay.com/link/2021-2022-RHS-Boys-Basketball-Camp

OR

Send checks to:
Roosevelt High School
attention: Erin Bailey
1410 NE 66th Seattle, Wash. 98115

Refunds subjected to $40 administrative fee. No refunds after July 8th

Email *

Roosevelt Roughriders

Camper first and last name: *

Parent/Guardian first and last name: *

Incoming Grade *

Date of Birth *

Current or ingoing school name: *

T-shirt size: youth small, medium, large, Xl or adult small, medium, Large or XL *

Insurance Provider *

Insurance Subscriber *

Insurance # *

Preferred Hospital if Emergency *

Emergency Contact #1 *

Emergency Contact #1 Phone number:

Emergency Contact #2 *

Emergency Contact #2 Phone number:

Any health conditions of camper?

PARENT/GUARDIAN RELEASE FORM-Roosevelt Boys Basketball Camp We agree that neither the school district, nor the staff of the Seattle Public Schools, nor the student organization of the Seattle Public Schools shall in any way be held liable for any accident or injury in any way received on account of or while engaged in any athletic activity sponsored by the District. We further agree that neither the District nor any of their staff or student organizations shall be responsible for the payment of any bills rendered for medical services as a result of such accidents or injuries. We also acknowledge that it is our responsibility to provide for any medical, disability or other insurance to mitigate any costs that may be unfortunately incurred as a result of participation in this activity. By signing below, I certify that I have read the above, understand its content, and agree to its terms. *

By checking box Parent/Guardian Agrees to Release Form

By checking box Participant Agrees to Release Form

Required

Gym Directions: Roosevelts gym entrance is through the double doors of the parking lot, by the football field. Enter from 12 AVE NE.

Any questions email Erin Bailey at eebailey@seattleschools.org

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