Grades 3-5 2018 Basketball Camp Registration & Medical Release of Liability
August 12-15, 2019
9:00-11:00 AM Grades 3-5 Boys & Girls (enrollment is limited to the first 35 players who register)
Name *
Your answer
Gender *
Birth Date *
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DD
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YYYY
Grade Entering in September 2019 *
Church Home *
Your answer
Parent Name *
Your answer
Parent Contact Cell *
Your answer
Email Address *
Your answer
Mailing Address *
Your answer
Emergency Contact & Relationship to Player *
Your answer
Emergency Contact Cell *
Your answer
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