Sports Crusaders Basketball Camp
Email address *
2019 Camp Details:
Cost: $55 per child

Date: Monday, July 8 - Friday, July 12

Time: 1 - 4 PM

Ages: Completed 2nd - 6th grades

Location: First Baptist Church, 210 North A Street, Farmington, Mo.

Registration Information:
First Name of Athlete: *
Your answer
Last Name of Athlete: *
Your answer
Address: *
City, State, Zip
Your answer
Date of Birth *
Your answer
Grade Completed in the 2016/2017 school year: *
Your answer
Athlete T-Shirt Size: *
Parent/Guardian Name: *
Your answer
Parent/Guardian Phone Number: *
Day, Evening, Cell
Your answer
Parent/Guardian E-mail (if different than above):
Your answer
Emergency Contact 1 Name: *
Your answer
Emergency Contact 1 Phone Number: *
Your answer
Emergency Contact 2 Name:
Your answer
Emergency Contact 2 Phone Number:
Your answer
1. Does the athlete have any known special needs or illnesses which might interfere with his/her participation in strenuous activity? If so, please explain. *
Your answer
2. Does the athlete have any severe allergies or reactions to drugs or medications? If yes, please explain *
Your answer
3. Is the athlete presently taking any medications or on any special diet or exercise restrictions? If yes, please list specific details (name of medications, dosage, etc.). *
Your answer
5. Are there any emotional/social disabilities that would be helpful for us to be aware of? *
Your answer
6. Is the athlete living with: *
Who will pick athlete up from camp? *
Your answer
Consent Statement
I, the undersigned parent/guardian, do hereby grant permission for my son/daughter, to attend the Sports Crusaders Camp. In order that my son/daughter may receive the proper medical treatment in the event that he/she may sustain injury or illness during the period of camp, I hereby authorize the camp staff to obtain or provide medical treatment for my son/daughter for such injury or illness during the camp, and I hereby hold the camp staff and sponsoring organization, as well as its representatives, harmless in the exercise of this authority.

I further understand that there is always a possibility that my son/daughter may sustain physical illness or injury while at the camp. If this occurs, I hereby authorize the camp staff and representatives to refer my son/daughter to a medical treatment center. I further acknowledge and understand that I will be responsible for any medical bills that may incurred on behalf of my son/daughter for physical illness or injury that he/she may sustain during the camp.

Understanding that there is always a possibility that my son/daughter may sustain physical illness or injury, I acknowledge and understand that my son/daughter is assuming the risk of such physical illness or injury by his/her participation, and I further release the sponsoring organizations and its representatives from any claims for personal illness or injury that my son/daughter may sustain during the camp. I further acknowledge and understand that my son/daughter will be expected to abide by and respect the rules of camp.

Please type your name below indicating that you agree with the above consent statement: *
Your answer
Photographs may be taken of your athlete during camp. Do we have permission to use photos of your athlete for church promotional purposes? *
Payment
To complete registration for camp, please follow the link below to pay $55 through Paypal. You do not need to have a paypal account to pay in this manner. Notice: We cannot hold a spot for your child until payment is made in full.

https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=SRAPXXPF6Z8KW

Join Us For VBS Too!
This year, First Baptist Church's "In The Wild" Vacation Bible School will be 8:30 AM-11:30 AM the mornings before Basketball Camp. You can drop your children off at VBS in the mornings and have them stay all day!

Registration will open up for VBS soon! Visit our website again in June to register.

(Note: VBS is free, but please send lunch with your children. They will eat in between VBS and Camp.)

Will Your Child Be Attending VBS? *
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