Application Form
Fifth Annual
Coach Sealy’s
Silver Bullets Summer Track Camp
Kenrick Sealy
2750 Joseph Ave. Apt # 9
Campbell, CA 95008
Tel. (408) 626-8651
Email:
kenricksealy80@hotmail.com
The following is the official entry form for the 2004 Coach Sealy’s Silver Bullets Summer Track Camp scheduled to begin on May 27th at Homestead High School. Please fill out and sign the necessary information that is applicable to you. Make checks payable to Kenrick Sealy
.
Name (s): ------------------------------------------------------------------------------------------------------------------
Parents ---------------------------------------------------------------------------------------------------------------------
Address: -------------------------------------------------------------------------------------------------------------------
Email address: ----------------------------------------------------------------------------------------------------------
School/Grade: -----------------------------------------------------------------------------------------------------------
Telephone: (H) ---------------------------------- (cell) --------------------------------
Fees: Check one Individual $ 110.00 ( ) or Family $150.00 ( )
I, the undersigned, totally agreed to participate in the aforementioned program with the knowledge that I am capable, fit and healthy to perform the task (s) that is/are asked of me during the length of the camp. I totally understand the terms and agreement of this contract and have all plans on executing them.
Signature -------------------------------------------------------------- Date: -----------------------------------------------