2 STRIVE Basketball Online Registration 2

1st Camper's Name *

First

Last

Birth Date *

Week attending *

July 8th-12th July 15th-19th Both Weeks (July 8th-12th & July 15th-19th)

Medical Information *

ANY SPECIAL MEDICAL INFORMATION s SHOULD KNOW (INCLUDING ALL KNOWN MEDICATION, FOOD, OR OTHER ALLERGIES AND ALL KNOW MEDICATION BEING TAKEN. PLEASE NOTE THAT NO MEDICATION CAN OR WILL BE SUPPLIED BY SUMMER SPORTS CAMP STAFF):

2nd Camper *

First

Last

Birth Date *

Week attending *

July 8th-12th July 15th-19th Both Weeks (July 8th-12th & July 15th-19th)

Medical Information *

3rd Camper *

First

Last

Birth Date *

Week attending *

July 8th-12th July 15th-19th Both Weeks (July 8th-12th & July 15th-19th

Medical Information *

4th Camper *

First

Last

Birth Date *

Week Attending *

July 8th-12th July 15th-19th Both Weeks (July 9th-13th & July 16th-20th)

Medical Information *

ANY SPECIAL MEDICAL INFORMATION s SHOULD KNOW (INCLUDING ALL KNOWN MEDICATION, FOOD, OR OTHER ALLERGIES AND ALL KNOW MEDICATION BEING TAKEN. PLEASE NOTE THAT NO MEDICATION CAN OR WILL BE SUPPLIED BY SUMMER SPORTS CAMP STAFF):

Parent/Guardian Information & Waiver Release

Parent/Guardian Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

How did you hear about us? *

Email *

Work/Home Phone Number *

Cell Phone Number *

EMERGENCY CONTACT (OTHER THAN NAME ABOVE, AUTHORIZED TO PICK UP CHILD OR TO CALL IN AN EMERGENCY. PLEASE NOTE THAT WE WILL ALWAYS CALL PRIMARY PARENT/GUARDIAN FIRST):

Waiver & Photo Release

I HAVE CLICKED THE LINK ABOVE AND READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.

There are 2 steps to registering for the STRIVE Basketball Camp
1. Please fill out the Registration Form and then click the Next button
2. Click Add to Cart to submit payment.

STRIVE BASKETBALL CAMP REGISTRATION FORM 2019

CAMPER INFORMATION

Parent/Guardian Information & Waiver Release

Waiver & Photo Release

There are 2 steps to registering for the STRIVE Basketball Camp1. Please fill out the Registration Form and then click the Next button​2. Click Add to Cart to submit payment.

STRIVE BASKETBALL CAMP REGISTRATION FORM 2019

CAMPER INFORMATION

Parent/Guardian Information & Waiver Release

Waiver & Photo Release

There are 2 steps to registering for the STRIVE Basketball Camp
1. Please fill out the Registration Form and then click the Next button
2. Click Add to Cart to submit payment.