Basketball Camp with Coach Jackson

Instructor: Coach Mariah Jackson
Please enter the time stamp shown on your orgsonline receipt. *
If you submitted payment in person, please enter the special time stamp code on your orgsonline receipt.
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Student Name *
Last, First
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Grade *
Parent Name *
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Parent Email *
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Parent Phone Number *
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Which camp session are you registering for? *
session I (June 19-22) or session II (June 26-29) Both sessions are 4pm-6:30pm
Sports Waiver: I understand that Voyager Academy employees and coaching staff are not liable for any injury, minor or major, incurred by my athlete during summer camps activities. *
I (we) the parent(s)/guardian(s) do hereby authorize the examination and emergency treatment of my son/daughter as may be indicated by emergency department physician of the closest medical facility while my child is under the supervision of the Voyager Academy staff. I authorize the Voyager Academy staff to obtain ambulance transport for my child in case of an emergency. UNDER NO CIRCUMSTANCES WILL THE STAFF OF VOYAGER TRANSPORT AN INJURED INDIVIDUAL. If a medical emergency occurs, 911 will be called and the ambulance/emergency vehicle will transport the injured individual. The parents/guardian are responsible for payment of the ambulance/emergency use. *
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