Boxing Camp

July 12-19, 2008

REGISTRATION FORM

              Name: _________________________________________________

              Address: _______________________________________________

              Contact Person: _________________________________________

              Phone :(H)_____________ (W)_____________(C)_____________

              Health Care #: __________________________________________

              Date of Birth: ___________________________________________

              Any Medical Problems?: ___________________________________

              Parent or Guardian

              Signature: _____________________________________________
 

                  Please bring to camp:         Personal toiletries, sleeping bag or bedding, swim suit,

                                                     Ball glove, gym shoes, pocket money (minimal amount)

                                                     Outdoor wear, skipping rope, boxing gear

                 Camp phone numbers:       Lodgepole (780) 894 2229, Sylvio’s Mobile (780) 863 1321

                 Any Questions?  Contact Sylvio Fex at (O) 780 427 5466 (M) 780 863 1321 or

                                                Email: s.fex@telus.net

              Cost per participant:  $ 150.00

                  Send Registration Form and Fee to:        Boxing Alberta,

                                                                                          11759 Groat Road,

                                                                                          Edmonton, AB T5M 3K6