2023 Team 45 Epic Sports Camp Registration Form

Epic Sports Camp 2023 Registration

June 12 - 16 5:30 - 8:45 pm $35
Child's Information
Child's Name*

First NameLast Name
Birth Date*

MonthDayYear
Age*
Current
Gender*

MaleFemale
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Select Sport*

Team 45
Select Shirt Size *
Guarantee by May 25th
Church (if any)
Name of Sibling(s) enrolled in Sports Camp
As a reminder, Team45 is only available for siblings (aged 4-5 years old) of current campers.
Parent/Guardian Information
Name*

First NameLast Name
Cell Number*

Area CodePhone Number
Home Number

Area CodePhone Number
E-mail
Emergency Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*

Area CodePhone Number
Alt. Phone Number

Area CodePhone Number
Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.*
Informed Consent and Acknowledgement

I give my child permission to participate in this activity, and give my permission to the leaders of this function to authorize any treatment deemed necessary by a licensed physician due to accident or illness during this activity.

I further give my permission for the use of any photo or likeness of my child to be used by the sponsoring organizations for their use in promotional materials.
Medical Release and Authorization

We realize that no activity is without the possibility of unforeseen hazards which could result in injury to an individual. As a parent or guardian, you are to be aware of your responsibility to instruct your child of the importance of conduct which will insure safety and enjoyable time while participating in this activity. By signing this form, you, as a parent, guardian, or other responsible party, agree to assume the risks and hazards which are inherent in this kind of activity. You also agree to absolve and hold harmless the sponsoring organizations and their representatives for damage, loss, or injuries to the child for whom you sign.
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.
Should be Empty:

Epic Sports Camp 2023 Registration