Steel Camp Registration 2022

August 1st – 5th

Early Steel: 1:00-3:00

Late Steel: 3:00-5:00

Steel Camp Registration 2022

Welcome back to Leopard Summer Camp! Our teachers have a great year planned for our Steel Leopards and it all starts here at camp. Camp is not optional for kids planning to participate in the upcoming 2022-23 Steel Leopard season. Specific details about Steel Leopard camp will be coming to you by email from Diane. Please complete this registration and all of the consent forms. You will receive a confirmation email once it is submitted successfully. If you do not receive a confirmation but know your credit card was charged, please contact Caroline. If your card was not charged, then you will need to resubmit the registration.

Steel Leopard's Name*
First Last
Steel Leopard camp session your child is registering for:
- Early Steel 1:00-3:00 Camp Session
- Late Steel 3:00-5:00 Camp Session
School attending in the fall:*
Address*
Street Address Address Line 2 City State ZIP Code
Parent/Guardian Name:*
First Last
Parent/Guardian Email (this is where your registration confirmation will be sent)*
Enter Email Confirm Email
Parent/Guardian Cell Phone*
2nd Parent/Guardian Name:
First Last
2nd Parent/Guardian Email
Enter Email Confirm Email
2nd Parent/Guardian Cell Phone
Emergency Contact Name (Other than those above):*
First & Last Name Relationship Cell Phone
Camp T-Shirt Size*
- Youth Small (6-8)
- Youth Medium (10-12)
- Youth Large (14-16)
- Adult Small
- Adult Medium
- Adult Large
- Adult XL
Photo & Liability Release*
I hereby give permission for the above-named student to attend The Louisville Leopard Percussionists (LLP) camp and/or classes. In consideration of the advantages of LLP, I agree that the Board of Directors of LLP, its agents, and employees shall be exempt from liability for damages, for bodily injury or property damage that might occur while participating in LLP, except to the extent of insurance liability as provided by law. I also understand that photos and videos are taken for publicity and distribution purposes. I hereby give my consent for any pictures in which my child appears to be used for purposes related to the promotion of LLP. I release LLP and all its members from any obligation or liability arising from use of such pictures.
I agree to this LLP photo and liability release.
Pediatrician & Medical Insurance Information
Pediatrician's Name Pediatrician's Phone Insurance Company Policy Number Member Number

Should a medical emergency arise, we will contact you immediately. If a hospital is required, we will send all kids to Norton Children's Hospital on Chestnut Street.
Allergies

(Please let us know if your child will be bringing an EpiPen/AuviQ or Inhaler)
Is there anything else LLP should know about your child? Any changes since participating last year? (medications, behavioral issues/diagnosis, special needs, etc.)
Camp Fee*
Price:
Camp fee includes camp t-shirt.
$0.00
Credit Card*
(Billing address must match address given above)

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Email
This field is for validation purposes and should be left unchanged.

Pediatrician's Name	Pediatrician's Phone	Insurance Company	Policy Number	Member Number