2025 SDC • Registration, Release & Payment

Athlete Information

Athlete's Name*

First NameLast Name

Age*

Shirt size *

Current Select Team or Little League *

Highest level played*

ex. Little League, 12 U select, etc

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Parent / Guardian # 1

Relationship*

Name (Parent / Guardian # 1)*

First NameLast Name

Cell Number*

E-mail*

example@example.com

Parent/Guardian # 2

Name (Parent / Guardian # 2)

First NameLast Name

Cell Number

Emergency Information (fill out only if different than Parent 1)

Relationship

Phone Number

Emergency Contact's Name

First NameLast Name

Alt. Phone Number

Is your child severely allergic to bee stings or have severe food allergies? If yes do they carry an epi pen and know how to use it? Does your child have asthma and do they need an inhaler?

Is there anything you feel important for us to know about your child's learning style or personality that may impact their experience at camp?

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by DBTR Camps/BUCK DT LLC, during the selected camp. In exchange for the acceptance of said child’s candidacy by DBTR Camps/BUCK DT LLC ., I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless DBTR Camps/BUCK DT LLC and all its respective officers, agents, and representatives from any and all liability for injuries to 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 DBTR Camps/BUCK DT LLC 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.

Medical Release and Authorization

As {emergencyContacts}Parent and/or Guardian of {athletesName}, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child {athletesName}, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to the DBTR Camps/BUCK DT LLC and its affiliates including Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorized on the dates and/or duration of the registered season.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

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.

Signature*

You can Pay Here before clicking "Submit Form" or you will get an Autoresponder with a link to pay. Payment deadline = June 13, 2025.

SUMMER SOFTBALL DAY CAMP 2025

$520.00 Quantity

Total

$0.00

Payment Methods

Debit or Credit Card

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

SUMMER DAY CAMP 2025