2021 Bustleton Bengals Dance Camp
Girls and Boys ages 5 and older
Child's Last Name *
Child's First Name *
Birthdate *
MM
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DD
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YYYY
Gender *
Uniform Shirt Size *
Street Address *
Apt
City *
State *
Zip *
Primary Phone *
Alternate Phone
Do you already receive Bustleton Bengals "One Call" automated phone messages?
Do you already receive Bustleton Bengals "One Call" email messages?
Parent/Guardian 1 *
Parent/Guardian 2
Parent/Guardian 1 E-mail Address
(Strongly suggested. The club sends out important dates and information via e-mail)
Parent/Guardian 2 E-mail Address
(Strongly suggested. The club sends out important dates and information via e-mail)
Parent/Guardian Permission
By submitting this form you are agreeing to the following:

WAIVER: (Please read before submitting this registration for your child and initial the block when requested below.)

I (the father, mother, or guardian) do hereby approve of the participation of my child or ward in any activities of the BBC. I represent that my child or ward to enjoy good health and is able to participate in competitive sports. I also release the BBC and any of its officers, directors, commissioners, managers, coaches or sponsors from all liabilities for personal injury or property damage resulting from participation in any sports activities in which my child or ward may take part. Also any photographs to be displayed on our website.

As a Board we are committed to being financially responsible to our families. We are asking for your support of this commitment by assuring necessary sports equipment is returned at the conclusion of the season.

IMPORTANT: Any child quitting a team during the season for an unapproved reason is subject to a suspension from club activities for one (1) full year. Once rostered on a team no refunds will be given. Determination to be made by the Athletic Director.

ALL PARENTS ARE EXPECTED TO VOLUNTEER A MINIMUM OF 5 HOURS DURING THE COURSE OF THE SEASON AT BENGAL EVENTS.
Initial that you have read and agree with the "waiver" (found above and on our website under the "Registration" tab) *
Initial that you have read and will comply with our "Code of Conduct" (found on our website under the "Code of Conduct" tab) *
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