Camp Atterbury - The X Count

Schedule

Packing List

Athlete's Name *

First

Last

Athlete's Email *

Athlete's Date of Birth

Athlete's Tshirt Size

Parent's Name *

First

Last

Parent's Email *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Signature *

I hearby attest that I am the parent/legal guardian of the athlete noted above. I give my child permission to attend the NRA National Matches and Smallbore Clinic at Camp Atterbury. I will not hold The X Count or its representative liable for any injuries that might occur. I have medical/hospital insurance to cover such injuries.

Total

$0.00

Authorize.Net *

Card Number

Expiration

Security Code