Flier Basketball Camp Registration Form
Please fill in all the required information below.
Email address *
Presented by NBA Player, Marcus Fizer
Camper First Name *
Your answer
Camper Last Name *
Your answer
T-Shirt Size *
Parent First Name *
Your answer
Parent Last Name *
Your answer
Grade (entering grade for 2017-2018 school year) *
Home Address - Street Number and Name *
Your answer
Home Address - City *
Your answer
Home Address - State *
Your answer
Phone Number (XXX)XXX-XXXX *
Your answer
Emergency Contact Person *
Your answer
Emergency Contact Phone Number (XXX)XXX-XXX *
Your answer
Any Medical Conditions *
Required
If yes to the question above, please explain:
Your answer
PARENT/GUARDIAN PERMISSION CONSENT FORM - I hereby authorize the camp staff to act for me according to their judgment in any emergency requiring medical attention and I hereby waive and release both the Clyde-Green Springs School District and its employees and camp employees from any and all liability stemming from any injury, illness, or accident incurred while at the clinic. I have no knowledge of any physical impairment which would be affected by the above named camper’s participation in the camp program as outlined. *
Required
Today's Date *
MM
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DD
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YYYY
Method of Payment (Please make checks out to Flier Boosters, INC) *
A copy of your responses will be emailed to the address you provided.
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