Basketball Camp Registration
Parent/Guardian please fill out the permission form for each child that is attending.
Student Name *
Age *
Phone Number *
Address *
Parent/Guardian Name *
By agreeing to this, the child referenced above has my permission to participate in the Midland basketball camp July 12-16,2021. I hereby release The Center & The Midland gym and their leaders from any liability in the event of an accident or injury to my child. I understand that every effort will be made to contact me in case of an emergency, but in the event that I cannot be reached, I authorize the treatment of this child by qualified medical personnel. By signing this, I verify that I have read and agree to all of the COVID guidelines as published on The Center’s website ( I also authorize The Center to use my child’s photograph in their publications. *
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