REGISTRATION

Clemson Summer Rugby Camp
July 17-20, 2012

Clemson Rugby Camp Registration Form

Name *

First

Last

Email *

Birthdate *

Grade in the Fall of 2012 *

School *

City *

State *

Primary Postion *

Secondary Position *

Years Experience *

Height *

Weight *

Home Address *

City *

State *

Zip Code *

Country *

Home Phone Number *

Roommate Preference *

Parent/Guardian Name *

First

Last

Parent/Guardian Email *

Parent/Guardian Primary Phone Number *

Camper Type *

Resident ($400) Commuter ($350) Resident/Commuter 2 for $500

T Shirt Size *

Submit

Registration will not be complete until receipt of camp fee along with the submission of the following forms below. Starred forms are required for registration. Please send checks payable to "Clemson Rugby" and forms to:

Clemson University
Fike Recreation Center
Clemson Men's Rugby
110 Heisman Street
Clemson, SC 29634

*Refund policy: All refunds, cancellations or transfer requests must be made in writing to mrugby@clemsonrugby.com. No refunds will be given for campers dismissed from camp for violation of camp rules. Cancellations made within 30 days of the start of camp are subject to a $50 administrative/cancellation fee as well as potential additional fees based on costs incurred prior to cancellation.

Clemson Rugby Camp Registration Form

*Code of Conduct

*Release of Liability - Adult

*Release of Liability - Minor

*Acknowlegement of Responsibility - Minor

*Housing Release of Liability - Adult

*Housing Release of Liability - Minor

*Health Examination Form

*Redfern Health Center Information Form

*Photography Consent Release - Adult

*Photography Consent Release - Minor

Permission for Student Vehicle Use

Permission to Administer Medication

2012 CLEMSON RUGBY SUMMER CAMP INTEREST FORM