2016 Michael Jordan Flight School Application

2016 Michael Jordan Flight School Application
If paying by check/money order, please print out, complete, sign, and mail this application along with full payment to:
Michael Jordan Flight School 11901 Santa Monica Blvd, Suite 598 Los Angeles, CA 90025
There is an 825 camper limit per session. Returning campers are not guaranteed enrollment.
The Michael Jordan Flight School may accept but also reject any paid camp registrants and/or applicants as we see fit.
Campers First Name
Campers Last Name
Current Age
Session Camper
Will Attend
Birthdate
Sex
Shirt Size
DAY CAMPER SESSION 1 (July 24 - July 28) BOYS
DAY CAMPER SESSION 2 (July 29 - August 2) BOYS & GIRLS
OVERNIGHT CAMPER SESSION 1 (July 24 - July 28) BOYS
OVERNIGHT CAMPER SESSION 2 (July 29 - August 2) BOYS & GIRLS
DAY CAMPER SESSIONS 1&2 (July 24 - August 2) BOYS
OVERNIGHT CAMPER SESSIONS 1&2 (July 24 - August 2) BOYS
Roommate
Request :
Parent or Guardian
Mailing Address
City
Primary Phone
State
Zip/Postal Code
Country
Alternate Phone
Parent/Guardian email address
Employer
Family Physician
Physician Phone
Date of Last Tetanus Shot
Medical Insurance Company CAMPERS WILL NOT BE ACCEPTED TO MICHAEL JORDAN FLIGHT SCHOOL WITHOUT MEDICAL INSURANCE
Group/Policy Number
Policy Holder
Known Allergies
By submission of this form, I hereby certify that my child is in good health and may participate in all camp activities. I will not hold the
University and/or MJFS Camp responsible in the event of an accident or injury as a result of his or her participation. I also authorize the
Michael Jordan Flight School sports medicine staff, the emergency medical services, and/or the local hospital/clinic to treat my child
for any illnesses/injuries sustained during camp. It is my responsibility to inform MJFS of any changes in my child’s medical status.
Additionally, I acknowledge and accept the terms of the Michael Jordan Flight School Cancellation Policy as stated on the MJFS
website. All photos associated with camp may be used in future advertisements and promotions for MJFS.
Parent/Guardian Signature:
Date