Player Registration Form
Junior Pioneer Summer Camp
Player Name
*
First Name
Middle Name
Last Name
Birth Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
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31
Day
Please select a year
2024
2023
2022
2021
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2019
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2015
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2012
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1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
T-Shirt Size
Youth Small
Youth Medium
Youth Large
Youth XL
Adult S
Adult M
Adult L
Grade in September 2024
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent E-mail
*
example@example.com
Mobile Number
*
Liability and COVID-19 Waiver
I hereby authorize a representative of Coach Nevolo Camps to take my child to a physician or hospital, should the need arise. I also release Coach Nevolo Camps and its staff from any and all liability in the event of an injury or illness requiring medical attention. I give permission to record any or all of my participation in this camp in photos/videos, and to use them only in a manner to promote or highlight future camp opportunities and camp experiences, without reimbursement of any kind. To the extent permitted by law, by entering this facility and participating in Coach Nevolo's camp you agree to keep harmless and indemnify both parties from and against any and all claims, loss, damage, injury, costs, charges, liability of exposure, however caused, resulting from or arising out of or any way connected with COVID -19. By signing and submitting this form you agree to the above guidelines and policies.
Signature
*
Allergies/Additional Comments:
My Products
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Jr Pioneer Camp Week 1 (6/24-6/28)
$
Free
Player Registration
0
1
2
3
4
Jr Pioneer Camp Week 2 (7/1-7/3)
$
Free
Player Registration
0
1
2
3
4
Jr Pioneer Camp Week 3 (8/19-8/23)
$
Free
Player Registration
0
1
2
3
4
Jr Pioneer Camp Week 4 (8/26-8/28)
$
Free
Player Registration
0
1
2
3
4
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