2005 REGISTRATION FORM

- Joaquim Cruz Running and Conditioning Camp -

Personal Info

Last Name:

First Name:

Gender: M F

Age:

Sports:

Address:

City:

State:

Zip:

Home Phone:

Business Phone:

Parent/Guardian:

Home Phone:

Business Phone:

E-mail:

Camp Information (Please Select a Session - Only one Session per registration form)

Session 1: July 11–15	Session 3: July 25–29
Session 2: July 18–22

Time: All Sessions from 9:00am to 11:00am

Where: La Jolla High School Track - 750 Nautilus La Jolla, CA. 92037

Cost: $150 per participant per session

Payment Information

Make all checks payable to Joaquim Cruz Fitness.

Please return registration form with payment to:

5858 Honors Dr., San Diego - CA. 92122

Waiver of Liability

In order that I/my minor child may participate in the activity or activities at the Joaquim Cruz Running and Conditioning Camp (the "JCR&CC"), I forever waive my right (and my child¹s right) to sue the JCR&CC and La Jolla High School (including directors, staff, employees and other contracted parties) for any injury I/my minor child may suffer arising out of my/my minor child's participation in these activities. I understand that by signing this document, all liability of the JCR&CC and La Jolla High School (including its directors, staff, employees, and other contracted parties) to myself/my minor child for any injuries I/my minor child may suffer arising out of my/my minor child¹s participation in the activity or activities at the JCR&CC will be forever extinguished.

Signature________________________________________________Date_________
(Parent or Guardian when minor)

Tel (858)550-9455 - Fax (858)550-9911

www.joaquimcruz.com
E-mail: joaquim@joaquimcruz.com