Freshman Survivor Camp, August 8th

REGISTRATION for Freshman Survivor Camp

Wednesday, August 8th   /   9:30 AM-12:30 PM (pick-up/drop-off by auditorium)


****ALL forms are due by August 1, 2012****


Please print all the information below.


Student Name: ______________________________________________________________

Phone: ___________________     T-shirt size: (Adult)  S____ M____ L____ XL____

Parent/Guardian: _____________________________         Parent E-mail: _________________________


I hereby request and grant permission to administrators at Centennial High School to provide reasonable care to my child named above in the event of injury or illness during the CHS Survivor Camp if I am not present. Such care may include, but is not limited to, first aid treatment, transporting to a medical facility or the summoning of emergency assistance. For and in consideration of allowing my child to participate in the CHS Survivor Camp, I, the undersigned parent or appointed guardian of the above child, do hereby agree to indemnify and hold harmless Centennial High School and its instructors from any and all liability from the above named child’s activities of any nature with said organization.


Signed: _____________________________________________ Relationship: __________________


Date: _____________________


Cost of Camp

To defer the cost of the camp, a $20.00 fee is necessary to cover the materials, T-shirts, and food.  Please make checks payable to Centennial High School.  In the memo portion of the check, please write “Freshman Survivor Camp 2012.”


Please return completed registration forms and checks to:

CentennialHigh School

C/O Survivor Camp/Shaun Manny

9310 Scott Road

Roswell,GA 30076

***Forms may also be dropped off in the front office***

*If you are mailing in the application, it must be postmarked by August 1, 2012

Forms postmarked after this date will not be accepted.*

NOTE: The Freshman Survivor Camp is not a substitute for CHS orientation. All students and parents must attend orientation on Thursday, August 9!



For CHS school use only: Check ___ (Check Number: _____) Cash ___   Other ___



What is the Freshman Survivor Camp?

The camp is run entirely by current CHS students and sponsored by the Executive Student Council.

Students will tour Centennial, learn study skills and time management, familiarize themselves with clubs and sports, and have an opportunity to meet the principal, Dr. Steven Miletto.

Students will also receive pizza and a “Freshman Survivor Camp” t-shirt.


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