Basketball Camp Registration

Westside Youth Basketball Club Winter 2025 - Registration

westkhoops.ca
Athlete Information
Athlete's Name*

First NameLast Name
Birth Date*

MonthDayYear
Grade -> JAN 2025*
Gender*

MaleFemale
Athletes skill level*
Years playing organized basketball*
Address*

Street Address

Street Address Line 2

CityProvince

Postal CodeCountry
T-Shirt / Jersey Size (YOUTH)*

SmallMediumLargeX-LargeOther
Parent / Guardian Information
Name - Parent / Guardian #1*

First NameLast Name
Cell Number*
E-mail*
example@example.com
Name - Parent / Guardian #2*

First NameLast Name
Cell Number*
E-mail*
example@example.com
Consent to Electronic Communication (email, text, social media, etc.)*
Emergency Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Cell Number*
E-mail*
example@example.com
Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.*
Is the athlete prescribed an inhaler? If yes, please explain any instructions.*
Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by this organization, during the selected leauge/camp. In exchange for the acceptance of said child’s candidacy by this organization. I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless this organization. All its respective officers, agents, and representatives from any and all liability for injuries to the said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against the organization. Including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including basketball. Some of these injuries include but are not limited to, the risk of fractures, paralysis, or death.
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.
E-Signature*

Clear
Did a FRIEND refer you to this LEAGUE? If yes, please provide their name here:

First NameLast Name

Choose Your GRADE / DIVISION:

Gr. 3, 4, 5 | COED | JAN - MAR | WINTER SEASONBORN 2016, 2015, 2014 | U8, U9, U10

$240.00CAD

Gr. 6 & 7 | BOYS | JAN - MAR | WINTER SEASONBORN 2013 & 2012 | U11 & U12

$300.00CAD

Gr. 8 & 9 | BOYS | JAN - MAR | WINTER SEASONBORN 2011 & 2010 | U13 & U14

$300.00CAD

Gr. 6 & 7 | GIRLS | JAN - MAR | WINTER SEASONBORN 2013 & 2012 | U11 & U12

$300.00CAD

Gr. 8 & 9 | GIRLS | JAN - MAR | WINTER SEASONBORN 2011 & 2010 | U13 & U14

$300.00CAD

Enter coupon

Total

$0.00CAD

KidSport / Jumpstart - Funding Application ID (Enter ID # Here):
Example: 2024-123456
Terms and Conditions*
Media Release Consent*
Should be Empty:

Westside Youth Basketball Club Winter 2025 - Registration

Athlete Information

Parent / Guardian Information

Emergency Information