Attack The Summer Registration

SAHQ ATTACK THE SUMMER Registration
Athlete Information
Athlete's Name*

First NameLast Name
Birth Date*

MonthDayYear
Grade*
MaleFemale
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Week 1 May 31 - June 4thWeek 2 June 7th - June 11thWeek 3 June 14th - June 18thWeek 4 June 21st - June 24thWeek 5 June 28th - July 2nd
Parent/Guardian Information
Name*

First NameLast Name
Cell Number*
Format: (000) 000-0000.
E-mail*
example@example.com
Emergency Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*
Format: (000) 000-0000.
Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.*
Is the athlete prescribed an inhaler? If yes, please explain any instructions.*
Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by SAHQ. during the selected camp. In exchange for the acceptance of said child’s candidacy by SAHQ. I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless SAHQ and all its respective coaches and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against SAHQ Including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including basketball.
Permission For Emergency Medical Treatment

As the legal parent or guardian, in the event of illness or accident, I give consent for SAHQ, SAHQ Coaching Staff to secure any and all necessary emergency medical care for my child. The undersigned gives permission to SAHQ., its owners and coaches to seek medical treatment for the participant in the event they are not able to reach a parent or guardian. I request that my child be transported to closest hospital in the event of an emergency. I hereby declare we have listed any physical/mental problems, restrictions, or conditions and/or declare the participant to be in good enough physical and mental health to participate in SAHQ Programs.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature
Thank You For Your Support!

We are looking forward to an amazing summer with all of our athletes.

Once you fill out and submit this form you will receive an invoice for weeks selected. If you would like to set up a payment plan or pay in cash please respond to the e-mail so we can set that up for you.

If you have any questions please e-mail us at sahqinfo@gmail.com

Thank you!
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SAHQ ATTACK THE SUMMER Registration