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Ballard Girls Basketball Fall Clinics
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Email Address 
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Player’s Name 
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Entering Grade Fall 2025
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Session(s) Attending 
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Tee Shirt Size 
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Emergency Contact Name 
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Relationship to Student
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Emergency Contact Phone Number (home or mobile)
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Emergency Contact Phone Number (work)
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Special instructions regarding the care of your child while at camp
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WAIVER:

I, the undersigned, hereby certify that I am the parent or legal guardian of the student named in this registration.

I hereby give permission for the Camp staff to seek during the period of the Camp, appropriate medical attention for my child, for the medical attention to be  given to my child, and for my child to receive the medical attention in the event of accident, injury or illness. I will be  responsible for any and all costs of medical attention and treatment.  

I, the undersigned, understand that Basketball is an active, physical sport and that injuries can often occur during  participation at Camp. I also understand that there will be more campers than staff at the Camp, and that my child  cannot receive individualized attention and individualized supervision at all times. I hereby acknowledge that my child  is physically fit and mentally capable of participating in practices, games, and all camp activities.  

I waive, release, and forever discharge Ani Garaventa (Head Coach & Camp Director), “Ballard High School”, and “Seattle Public School District” and any & all related staffs, officers, agents, employees, representatives, successors, volunteers, students, and assigns from any and all liability claims, demands, actions, and cause of action whatsoever arising out of or related to any loss, personal injury,  or property damage that may be sustained or occur during the participation in camp activities or while at camp.  

I give permission for “Ballard High School“ Students to take photographs of my child while engaged in Camp activities  for the sole purpose of team promotion, and I understand that my child’s identity will remain anonymous in  conjunction with any photograph used in marketing.  

Clicking “Accept” indicates that I have provided true information and have read, understand and agree to all  statements on this entire form and on any other form required by the Camp.  

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I understand that my spot is not secured until this form is submitted and payment is received on the first day of attendance.
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