Reset Form 2017 Michael Jordan Flight School Application If paying by check/money order, print, 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. Michael Jordan Flight School may accept but also reject any paid camp registrants and/or applicants as we see fit. As the Michael Jordan Flight School is primarily a domestic event, Michael Jordan Basketball Camp West Coast, Inc. d/b/a Michael Jordan Flight School reserves the right to cap the number of international participants. Campers First Name Campers Last Name Current Age Session Camper Will Attend Birthdate Sex Shirt Size DAY CAMPER SESSION 1 (July 28 - August 1) BOYS DAY CAMPER SESSION 2 (August 2 - August 6) BOYS & GIRLS OVERNIGHT CAMPER SESSION 1 (July 28 - August 1) BOYS OVERNIGHT CAMPER SESSION 2 (August 2 - August 6) BOYS & GIRLS DAY CAMPER SESSIONS 1&2 (July 28 - August 6) BOYS OVERNIGHT CAMPER SESSIONS 1&2 (July 28 - August 6) BOYS Roommate Request : Parent or Guardian Mailing Address City State Primary Phone 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
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