Spring Break Basketball Camp Registration Form

SPRING BREAK CAMP - Registration Form

March 13th - 16th

(3rd Grade through High School)

The RYG Arena - 5819 RENDON BLOODWORTH RD

www.rygbballtx.com
Athlete Information
Player Name*

First NameLast Name
YesNo
Guardian / Parents Names*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone*

Area CodePhone Number
Cell Phone

Area CodePhone Number
E-mail*

Basketball skill level*

	1	2	3	4	5

1 is Begginer, 5 is Advanced

Important Notes

· Dress appropriately. Come ready to work. This will e a challenging camp for everyone.

· No food in the gym.

· Keep the gym clean.

· Fee: $100 (RYG ACADEMY MEMBERS)

$175 (New Campers).

Payments can be made via Zelle, Venmo or Cash. Secure your spot now.

1. Venmo : @rygbball

2. Zelle: raiseyourgamebasketball@gmail.com

3. Paypal : raiseyourgamebasketball@gmail.com
Emergency Contact & Health Insurance Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*

Area CodePhone Number
YesNo
Please describe*
Parental Permission For Emergency Treatment

In the event of illness or accident, I give my permission for emergency treatment by qualified medical personnel for my child, and I authorize the person in charge to take my child to:
I give consent for the facility to secure any and all necessary emergency medical care for my child.
Name of Physician / Emergency Medical Care Facility
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Release of Liability

Although the safety of all sport activities is the primary concern, indoor sport activities at Raise Your Game facilities may cause injuries and/or death. I expressly assume the risk of injury, death, and/or illness arising from any cause, and agree to waive the right to pursue any claim against the Raise Your Game and the persons in charge.
YesNo
Confirmation E-mail*
Signature*

Powered by Jotform SignClear
After completing this form, please click Submit Form. You will receive a confirmation email. If you do not receive the email within a few minutes, please check your spam; otherwise, please contact us at gxtt.basketball@gmail.com.
Should be Empty:

Release of Liability