TMP ELITE BASKETBALL CAMP REGISTRATION

TAYLOR MADE PREP ACADEMY

APPLICATION
Name*

First NameLast Name
Gender
Height
Date of Birth*

MonthDayYear
Mailing Address*

Address Line 2

CityState / Province

Postal / Zip Code
Country
Phone Number*

Area CodePhone Number
Email*
Insurance Provider*
Group Number*
Member ID*
School Name (Last School)*
School Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Country
School Phone Number

Area CodePhone Number
Current Grade*
Grade Point Average*
Graduation Year*
Shirt Style*

YouthMen'sWomen's
Shirt Size*

SmallMediumLargeX LargeXX Large
Complete "Parent" section if student is under 18
Parent's Name

First NameLast Name
Parent's Phone Number

Area CodePhone Number
Parent's Email
Parent Signature

Clear
Please verify that you are human*
Should be Empty: