Health Form

Health Form (Printable PDF)

Please download, fill out and either return your completed form to the Health Office by fax (518-452-9817) or mail:
Health Office
Christian Brothers Academy
12 Airline Drive
Albany, NY 12205

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Sports Camp 2023

Step 1 of 3

33%

Jr. Camp
Price:
Week 1
Price:
Week 2
Price:
Name*
First Last
Address*
Street Address Address Line 2 City ZIP / Postal Code
Birthday*
Month
Day
Year
Height*
Weight*
School*
Grade in September '23*
Parent/Guardian*
First Last
Email*
Phone*
Medical Concerns
Check Appropriate Session(s) Information and T-Shirt Size
- Junior Camp Week 7/5 - 7/8
Jr. Camp Week 7/5 - 7/8*
- Full Day ($200)
- Week 1 7/17 - 7/21
Week 1 7/17 - 7/21*
- Full Day ($300)
- Half Day ($200)
- Week 2 7/24 - 7/28
Week 2 7/24 - 7/28*
- Full Day ($300)
- Half Day ($200)
Sibling Discount
- Yes, we have already enrolled a sibling in the 2023 CBA Sports Camp
If you have already registered one child for 2023 CBA Sports Camp you can claim a $25 on subsequent sibling registrations
Sibling Discount
Price:
T-Shirt Size
Adult
- S
- M
- L
- XL
- XXL
Youth
- S
- M
- L
- XL

Carrier*
Policy Holder's Name*
First Last
Policy #*
Group #*
Emergency Contact other than parent
First Last
Phone
Phone
Medical Release: I, the undersigned, realize that participation in any sport may cause physical injury. In the event of an injury, I authorize the appropriate camp personnel to administer first aid or care as deemed necessary. I release Christian Brothers Academy, the camp staff, its officers and any representatives of any claims for damages to persons or property while at the camp.
Signature*

Credit Card*
Card Details
Cardholder Name
Total
$0.00