STRIVE Basketball Online Registration

There are 2 steps to registering for the STRIVE Basketball Camp
1. Please fill out the Registration Form
2. Click the NEXT BUTTON at the bottom of the page to complete the registration.

STRIVE BASKETBALL CAMP REGISTRATION FORM 2019

CAMPER INFORMATION

* Indicates required field

1st Camper's Name *

First

Last

Birth Date *

Week attending *

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

Entering Grade *

Age *

Sex *

Approximate Height *

Camper's Shirt Size *

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)

Entering Grade *

Age *

Sex *

Approximate Height *

Camper's Shirt Size *

Medical Information *

3rd Camper *

First

Last

Birth Date *

Week attending *

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

Entering Grade *

Age *

Sex *

Approximate Height *

Camper's Shirt Size *

Medical Information *

4th Camper *

First

Last

Birth Date *

Week Attending *

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

Entering Grade *

Age *

Sex *

Approximate Height *

Camper's Shirt Size *

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

Email *

Cell Phone Number *

Work/Home Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

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):

1st Emergency Contact Name *

1st Emergency Phone Number *

2nd Emergency Contact *

2nd Emergency Phone Number *

How did you hear about us? *

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.

Name (First & Last) *

Date *

There are 2 steps to registering for the STRIVE Basketball Camp1. Please fill out the Registration Form ​2. Click the NEXT BUTTON at the bottom of the page to complete the registration.

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
2. Click the NEXT BUTTON at the bottom of the page to complete the registration.