MC Hoops Basketball Camp 2019
Welcome to the online registration form for MC Hoops Basketball camp taking place July 22-26, 2019. Please take the time to fill out this form for each child you are registering. Once you have completed the registration form, payment can be made in the following ways:

(Cost: 1 Child: $110; 2 children: $190; 3 children: $250; $60 for each additional child).
1. E-transfer payment to
2. Paypal on the MC Hoops website by clicking the Paypal icon (credit card also accepted without Paypal account).
3. Cash or cheque in person at the church office (500 Indian Creek Rd. W., Chatham)
4. Mail a cheque payable to Maple City Baptist Church at 500 Indian Creek Rd. W. Chatham, ON. N7M 0P4

Once the form is complete, you will receive a confirmation within two weeks from Maple City. If you do not hear from us, please contact the church to ensure your child is registered. The number of registrations accepted will be limited to the first 30 campers in each age group (this year we are hoping to expand to four age groups).

If you have any questions about this form, please call Pastor Dan at 519-351-2004 or email Thank-you. Please fill out this form in its entirety.

Visit: for more information.

Participant's Name (first and last) *
Your answer
Participant's Date of Birth (mm/dd/yyyy) *
Your answer
Participant's Address *
Your answer
Email Address *
This email will be used to convey important information about the camp.
Your answer
Gender *
Is anyone else in the family registering for MC Hoops this year?
This will help us apply the proper discounts
Grade in September 2019 *
Location subject to change. Children will be moved to appropriate age and skill levels on the first day of camp if necessary or requested. Please call if you have any questions or requests.
T-Shirt Size *
Parent/Guardian Name(s) & Phone Number(s) *
Your answer
Secondary Emergency Contact Name(s) & Phone Number(s)
Your answer
Secondary Emergency Contact Consent to Pick-up
Please sign (digital signature) if your secondary contact will be picking up your child or they may come in case of emergency: I am the legal guardian of the child with full authority to make decisions with respect to the child. I confirm that the person listed as the secondary contact above is authorized to pick up my child during or at the end of the camp days; I hereby authorize you to release the child into the custody of the above individual.
Your answer
Medical Information: Name and Phone Number of Family Doctor
Your answer
Medical Information: Allergies
Please list any and all allergies the participant has and the usual treatment of these allergies (lunches are not provided, but nut-free snacks will be available throughout the week).
Your answer
Medical Information: Medications/Medical Conditions
Please list any medical conditions the staff of MC Hoops should be aware of as well as medication that the child will need to take during their time at camp.
Your answer
Past Basketball Experience
Please select all that apply
Permission to Use Photos *
By checking this box, I give permission for my child's picture to be used anonymously for advertising related to the camp and/or on the MC Hoops website
Do you give Maple City Baptist Church permission to contact you about other events that may be of interest to you or your child?
Digital Signature - Parent/Guardian *
After you have reviewed this form, please sign below to give your child permission to attend MC Hoops Basketball Camp
Your answer
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