Camp Registration Form

Camp Registration Form
Please note below:

Registration: If you have more then one athlete/player participating in our OBA camp please make sure to fill out a form for each.

Payments: All payments can be made by e-transfer to openbasketballacademy@gmail.com

Please put the athletes first and last name in the Subject line

Answer to the security question is basketball
Athlete/Player Information
What camp is the player/athlete registering for?*
Athletes Name*

First NameLast Name
Athletes Alberta Health Care Card
Athletes Birth Date*

MonthDayYear
Athletes Age*
Athletes Gender*
Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
Athlete medical conditions/allergies
Parent)s)/Guardian Information

Please fill out this portion of the form if you are filling out the form for an athlete/player who is under the age of 18. If you are over the age of 18 you can move to the next part of the registration form.
Parent(s)/Guardian Name

First NameLast Name
Parent(s)/Guardian E-mail
example@example.com
Parent(s)/Guardian Phone Number

Area CodePhone Number
Emergency Contact Information
Emergency Contact Name*

First NameLast Name
Emergency Contact Relationship to you*
Emergency Contact Primary Phone Number*

Area CodePhone Number
Emergency Contact Secondary Phone Number

Area CodePhone Number
Consent
I give my permission for photographs to be used in promotional materials, websites, newspaper articles or future camp brochures.*

I agreeI do not agree
I have read and understand the following:
- In the event of an emergency, I give consent for the Camp Staff or designated appointee to authorize on my behalf all procedures(including admission to the hospital and necessary treatments) if contact cannot be made with the parents/guardians or emergency contacts.
- Yes, I certify that the registrant on this form is in good health and can vigorously participate in the Open Basketball Academy.
- Yes, I consent to the full participation of the aforementioned registrant, fully recognizing and, accepting the inherent risks involved in sporting activities.
- Yes, I release and hold harmless, the Open Basketball Academy all liability or damage to person or property howsoever caused, resulting from participation by the aforementioned registrant in the program.
- Yes, Freedom of Information: Pursuant to Section 39 (2) of the Freedom of Information and Privacy Act, you are hereby notified that your personal information is being collected for the purpose of assisting program director or staff in the event of an emergency, mailing information regarding the Open Basketball Academy, and for creating internal records.
Signature Parent(s)/Guardian(if under the age of 18)

Clear
Parent(s)/Guardian Name(if under the age of 18)

First NameLast Name
Date

MonthDayYear
Date
Signature Athlete

Clear
Athletes Name(if over the age of 18)

First NameLast Name
Date

MonthDayYear
Date

Camp Registration Form

Athlete/Player Information

Parent)s)/Guardian Information

Emergency Contact Information

Consent