Camp Registration - Pre-Nationals High Performance Camp 2024

Registration form: Summer Nationals 2024 Hi Performance Camp
June 17 -21, 2024
9:30 - 3:45

Enroll my child in the Summer Nationals 2024 High Performance Fencing Camp. Bring a water bottle, and lunch. Must have full competition gear. Fencer does not have to be going to summer nationals to attend this camp.but check with your coach if you wish to attend.

Club members $450.00 Non members $500.00

Prepay by April 30 and save 10%. Prepay 30 days in advance and save $25.00

Participant Name: Last

Participant Name: First

Participant age

Male or Female

Camper has no known allergies or medical conditions EXCEPT as known here (describe allegens, conditions, severity of reactions, treatment)

Your First & Last Name: Parent/LegalGuardian

Telephone number Including. area code:

Street Address

City

State

Zip Code

Emergency Contact during Camp: Name and phone number(s)

LIABILITY WAIVER & CONSENT : I am the parent and/or legal guardian/adult participant of the participant named above. I hereby give consent for him/her to participate in fencing instruction, bouting, games, physical fitness, field trips and any camp activities. I recognize and agree that participation in this camp and related activities includes strenuous physical activity and/or activities that may be potentially hazardous. I/we hereby accept the risks, waive and release all liability and all claims against PDX Fencing, its coaches, staff, agents, and volunteers for any injury or death to participant caused by accident or negligence. CONSENT FOR MEDICAL TREATMENT: This is to certify that I give my written consent to PDX FENCING and it's representatives to obtain medical care from any licensed physician, athletic trainer, hospital, clinic, paramedics, for any injury or illness that may arise during the fencing camp or while on the PDX Fencing premises. I understand that attempts to reach the emergency contacts I listed in this form will be made immediately.

Payment: Club Members: $450.00. Non members $500.00. Pre-pay 30 days in advance and save $25.00. Payment can be mailed in or paid while in the club. You can also pay online using the free Zelle or Venmo app. We accept: VISA/MC/DISCOVER/ZELLE. , By mail to: PDX Fencing, 5645 S.W. Arctic Drive, Beaverton, OR 97005:

Payment

ZELLE: pay to email [email protected] VENMO: pay to @PDXFencing Mail in check (PDX Fencing 5645 SW Arctic Drive Beaverton OR 97005) or drop check in payment box in the club VISA/MC/Discover - I will phone in my card or come in with payment Send me an invoice at my email that I can pay online $2.99 online processing fee with a credit credit card

Registration form: Summer Nationals 2024 Hi Performance CampJune 17 -21, 20249:30 - 3:45

Club members $450.00 Non members $500.00

Prepay by April 30 and save 10%. Prepay 30 days in advance and save $25.00

Registration form: Summer Nationals 2024 Hi Performance Camp
June 17 -21, 2024
9:30 - 3:45