2023 CAMP BOWERS' Registration & Waiver Form

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Email *

CAMPER'S NAME *

Please Enter Camper's First and Last Name

CAMPER'S GENDER *

Please Choose One

CAMPER'S AGE *

Please Enter Camper's Age

CAMPER'S DATE OF BIRTH *

Please Enter Camper's Date of Birth

YYYY

WHICH CAMP WILL YOUR CAMPER BE ATTENDING? *

Please Choose Which Camp You Plan on Attending

WHICH SIZE BASKETBALL FOR YOUR CAMPER? *

27.5" - Baby Ballers Camp Basketball for Boys & Girls

28.5" All Girls + Boys 5th grade or under

29.5" - BOYS ONLY entering the 6th grade or above

SHIRT SIZE *

Choose the Shirt Size for the Camper

WHAT GRADE WILL THE CAMPER BE THIS FALL (2023) *

Please Enter the Grade The Camper Will Be In This Fall

WHAT IS THE CAMPER'S SKILL LEVEL? *

Enter The Camper's Skill Level. If In Between 2 Selections, Please Click Both That Apply

Beginner

Intermediate

Advanced

Elite

Required

HOME ADDRESS *

Enter Your Home Address Including Street Name

CITY, STATE & ZIP CODE *

Please Enter Above Information

HOW DID YOU HEAR ABOUT CAMP BOWERS? (If registering as a sponsored camper, a scholarship camper, or as a camper whose family won an auction, please provide the organization or person's name in which you received this opportunity from) *

PARENT/GUARDIAN EMAIL ADDRESS *

Please Enter Your Email Address

PARENT/GUARDIAN'S NAME *

Please Enter Parent or Guardian Name

PARENT/GUARDIAN'S PHONE NUMBER *

Please Enter Phone Number

EMERGENCY CONTACT'S NAME *

Enter an Emergency Contact Name Other Than The Parent's/Guardian's Name (if possible)

EMERGENCY CONTACT'S TELEPHONE NUMBER *

Enter an Emergency Contact Number

EMERGENCY CONTACT'S RELATIONSHIP *

Enter The Emergency Contact Relationship

Drop-off & Pick-up: It is imperative for the camper to be in the gym READY TO GO 15 minutes prior to start time. This will allow them time to get up some shots before camp drills begin. The camper shall be picked up “on-time” at the conclusion of each day. *

Please Enter Your Initials To Acknowledge the Drop Off & Pick Up Policy

Parental Waiver & Release Statement-In the very rare case of a medical emergency, I understand that my child could be transported to the nearest available medical facility by the local emergency unit for treatment if the local emergency resource (police, rescue squad) deems it necessary. The child will be transported at the expense of your primary medical coverage. It is also understood that in some medical situations, the staff will need to contact the local emergency resource before notifying the parent, child’s physician, and/or other adult acting on the parent’s behalf. *

Choose Yes to Acknowledge and Accept the Following Statement: I, the undersigned, have read this release and understand its terms. I execute it voluntarily and with full knowledge of its significance.

Parent Statement (Enter Camper Full Name Below) *

I hereby state that my child, (ENTER CAMPER FULL NAME BELOW) is in good mental and physical health condition to participate in the activities provided by Camp Bowers (including but not limited to all aspects of basketball). I am fully aware that any form of athletic activity creates the possibility of serious injury, and in rare cases death. In addition, I also agree not to hold LBO Sports/Camp Bowers and/or Columbia Parks & Recreation (Columbia Sports Fieldhouse) responsible in the event that my child engages in inappropriate conduct (including, but not limited to disruptive or volatile behavior) and that LBO Sports/Camp Bowers has the right to dismiss him/her from the camp. I further attest that the Information contained in this form is correct to the best of my knowledge. In conclusion, I have agreed to all of the conditions within this form, and I agree to comply.

Camper's Medical Problems *

Please Enter Any Medical Problems

Camper's Allergies (Please include food allergies) *

Please List Any Known Allergies of the Camper

Current Medications *

Please List the Camper's Daily Medications

Family Doctor Information *

Please Enter the Name of the Camper's Physician and Their Telephone Number

Photography *

I also grant permission to the staff of Camp Bowers, to photograph and/or videotape my child for educational, motivational, or promotional purposes for LBO SPORTS' usage. Please choose yes to accept, if you do not accept choose no.

Online Signature of Parent/Guardian of Above Mentioned Camper(s) *

Please Enter Your Full Name Below to Acknowledge and Accept the Following Statement: I, the undersigned, have read this release and understand its terms. I execute it voluntarily and with full knowledge of its significance.

Camp Admission Fee is: $110.00 for CAMP BOWERS "BABY BALLERS" ages 5-7 & $165.00 for CAMP BOWERS Ages 8-16. Applicable Discount Codes are only valid for ONLINE REGISTRATIONS!!! .....If Paying By Check, Please Mail The Check to the Address Below:

LBO Sports Attn: Laurence Bowers,1301 Haxby Ct., Columbia, MO 65201

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Payments: Accepted Payments Forms Are: Check, Credit/Debit via Camp Website, and/or PayPal via Camp Website Checkout. ****Checking out via the Camp Website's PayPal Option DOES NOT REQUIRE you to have a PayPal account**** REGISTRATION IS NOT COMPLETE UNTIL PAYMENT IS RECEIVED! *

Please Select Your Payment Method. Confirmation of Payment Received will be available upon request.

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