Please provide the first name of at least one of the participant's parents.​​​​
Please provide the last name for the parent(s) listed above.​​​
Please provide a contact email for at least one of the participant's parents.​​
By checking the box below and by submitting this form, I authorize enrollment in the camp of the above-named participant and submit that he is physically fit to participate in strenuous activity and waive, release, discharge, hold harmless, and promise to indemnify Canisius High School, its staff, affiliate entities, and employees from and against injury, impairment, recurrence of any undisclosed pre-existing illness or injury prior to the camp, and all claims, alleged or asserted, or causes of action arising out of or in connection with the participant's activities in this camp. Any photos, recorded audio or video, and written materials created for and/or during the camp are property of Canisius High School and may be used for promotional purposes at the discretion of Canisius High School. 
If there is any additional information we should know about this participant, please add it here.​​

If you have additional questions, please contact Canisius director of athletics Mr. Jim Mauro at mauro@canisiushigh.org.