Springfield MA Annual Basketball Camp Presented by Parent Villages Hosted by Professional Players United
Please complete all fields in their entirety in order to register your child for the Basketball Camp. Please only submit one form per child. Your child must be within the ages of 10 - 16. Camp dates are 8/20/2021 - 8/22/2021 from 9am to 1pm EST (subject to change). Both Breakfast and Lunch will be provided during the camp. Please indicate below if you would like to apply for sponsorship and/or transportation. The cost of registration is $75 per child. Payment is to be submitted via PayPal to: RSJSportsManagement@gmail.com
Child's Name:
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First Name
Last Name
Child's DOB:
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Month
-
Day
Year
Date
Parent or Legal Guardian's Name:
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First Name
Last Name
Address:
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent or Legal Guardian's Email:
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Confirmation Email
example@example.com
Parent or Legal Guardian's Phone Number:
*
Please enter a valid phone number.
Please upload a copy of your child's birth certificate for proof of age.
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Please upload a copy of your health insurance information.
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Emergency Contact:
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First Name
Last Name
Emergency Contact's Phone Number:
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Please enter a valid phone number.
Please indicate your child's shirt size:
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Please Select
Adult Mens Small
Adult Mens Mediums
Adult Mens Large
Adult Mens XL
Adult Woman's Small
Adult Woman's Medium
Adult Woman's Large
Adult Woman's XL
Youth Small
Youth Medium
Youth Large
Please indicate your child's shorts size:
*
Please Select
Adult Mens Small
Adult Mens Mediums
Adult Mens Large
Adult Mens XL
Adult Woman's Small
Adult Woman's Medium
Adult Woman's Large
Adult Woman's XL
Youth Small
Youth Medium
Youth Large
By signing below, I voluntarily and knowingly assume all risks incidental to the activities performed at the Springfield MA Annual Basketball Camp presented by Parent Villages, hosted by Professional Players United. I will not hold the camp or any of its affiliates liable for any injuries incurred during the duration of the camp. I do hereby authorize the camp to consent to the medical, dental or surgical diagnosis or treatment, and hospital care which is deemed advisable by, and is to be rendered under general or special supervision of, any licensed physician and surgeon licensed, whether such diagnosis or treatment is rendered at the camp or at the hospital. I further understand the camp or any of their affiliates are not responsible for the costs incurred for medical care. Additionally, my child will adhere to the Code of Conduct policy and if they do not, they will be dismissed immediately from the camp and will not be allowed to return. If my child is dismissed from the camp, I understand that my registration fee will not be returned to me.
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Please check here if you would like to apply for a sponsorship for your child for the camp registration fee.
Please check here if your child will need transportation to and from the camp.
If you are affiliated with a local community center or group, please indicate which one below.
If you have any questions, please see the website: www.RSJSportsMarketingandManagement.com
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