BASKETBALL CLINIC REGISTRATION - WESTWOOD FIELDHOUSE

Direction Up Basketball Clinic powered by Westwood Fieldhouse (Basketball Clinic ONLY)*

Session 1: 9:00 AM - Noon - Grade 2 -6Session 2: 12:30 PM - 3:30 PM - Grade 7 - 12

Camper's Full Name*

First NameLast Name

Parent/Guardian Email*

example@example.com

Daytime Phone*

Area CodePhone Number

Camper's School*

Camper's Age*

Camper's Grade*

Shirt Size (Youth)*

Payment Type*

By checking this box you agree with our refund policy: In order to receive a refund, your written cancellation notice must be received 48 hours in advance of the start of the camp.*

I agree

By checking this box you agree: I, the undersigned, hereby certify that I am the parent or legal guardian of the camper named above. During the period of the camp, I hereby give permission for the camp, staff, and volunteers to seek appropriate medical attention for my child, for the medical attention to be given to my child, and for my child to receive the medical attention in the event of an accident, injury or illness. I shall be responsible for any and all cost of medical attention and treatment. I, the undersigned, understand that basketball (sport) is an active, physical sport and that injuries may often occur during my child's participation at camp. I also understand that there will be more campers than staff and volunteers at the camp, and that my child cannot receive individualized attention and individualized supervision at all times. I hereby acknowledge that my child is physically fit and mentally capable of participating in drills, games, and all camp activities. I, the undersigned, hereby acknowledge and understand that Direction Up Basketball Camp is a privately run sports camp. The camp is neither sponsored, controlled, nor supervised by any organization, but rather is under the sole sponsorship, control, and supervision of Direction Up Basketball Camp LLC. I waive, release, and forever discharge Direction Up Basketball Camp LLC and the aforementioned staffs, volunteers, officers, agents, employees, representatives, successors, and assigns from any and all liability claims, demands, actions, and cause of action whatsoever arising out of or relating to any loss, personal injury, or property damage that may be sustained or occur during the participation in camp activities or while at camp. I give permission for "Direction Up Basketball Camp" to take photographs of my child while engaged in camp activities for the sole purpose of advertising and publicity, and I understand that my child's identity will remain anonymous in conjunction with any photographs used in marketing, furthermore, I hereby release any right to compensation during the use of any photographs. By checking, I agree below indicates that I have provided true information and have read, understand and agree to all statements on this entire form and on any other form required by the camp.*

I agree

I'll be paying by check. (Make check out to Direction Up Basketball LLC and send to PO Box 39026, Solon, OH 44139)

Check

(Check the box below if you are paying online.)

BASKETBALL CLINIC $185.00

(a $10.00 processing fee was added)

Total $0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

BASKETBALL CLINIC REGISTRATION - WESTWOOD FIELDHOUSE

Camp Registration Payment