HOOPSKILLS Summer Camp Registration Form

Camp Information

Location: Almonte High School

Date: July 7-11, July 14-18, July 21-25

Ages: 9-14 (for students entering grade 5-9 in the fall of 2025)

Time: 9:00 - 12:00 (arrive 15 min early each day)

Cost: $175 per child

*Registration Cost includes a t-shirt

*Bring your own ball labeled with your child's name on it

*Bring your own water bottle labeled with your name on it

*Please compelete a separate form for each child.
HoopSkills Summer Camp Registration

Presented by Scott Meeson & Jumpshots at Almonte High School
Athlete Information
Athlete's Name*

First NameLast Name
Returning Athlete

YesNo
Birth Date*

MonthDayYear
Grade
Gender*

MaleFemale
Please select the dates your child will attend.*

July 7-11, 2025July 14-18, 2025July 21-25, 2025
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
1st Parent/Guardian Information
Name*

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

First NameLast Name
Phone Number
Please enter a valid phone number.
Cell Number
Please enter a valid phone number.
Email
example@example.com
Transportation

If your child/children will be picked up by someone other than a parent - please make note of the name(s) in the next section.
Please check one*

Parent pick up and drop offWalking (self or with others)Pick up by other adult (friend, grandparent)
Name(s) & Number of Persons (other than parents) who are permitted to pick up your child/children.
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Emergency Contact - in case parents are not reachable
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*
Alt. Phone Number*
Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.*
Is the athlete prescribed an inhaler or EPI PEN? If yes, please explain any instructions.*
Payment Options

Please choose one option.
E-Transfer - we will contact you with further information shortly - please do NOT send any monies until we have provided the account information/email address.Cash - please bring cash on the first day, in a sealed envelope with your Athlete's name on it.
Informed Consent and Acknowledgement

I hearby give my consent for the above mentioned Athlete to play Basketball under HoopSkills/Scott Meeson. I and the above mentioned Athlete agree to abide by the rules of the camp. I hearby acknowledge that Basketball is a physical sport and in so doing I will not hold HoopSkills, Scott Meeson or anyone affiliated with this camp or representatives responsible for any injuries caused to the Athlete arising out of his/her participation in the camp. I agree and indemnify HoopSkills/Scott Meeson or anyone affiliated with the camp for any such injury. I further assume full responsibility for any damaged caused by the Athlete to any gym premises or equipment. I also give my consent for the use of any photographs taken of the Athlete,while playing Basketball for use on HoopSkills social media platforms. My signature acknowledges that I accept responsibility for the fees and that I have read and agreed to the terms and conditions listed above. I confirm that I have read this release and waiver before signing it and I understand that it is binding not only on me and the Athlete but also on our heirs, executors and assigns.
Medical Release and Authorization

As Parent and/or Guardian of the named athlete, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, 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 and x-ray examination 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 HoopSkills 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.
Date

MonthDayYear
Date
Signature

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HoopSkills Summer Camp Registration

Athlete Information

2nd Parent / Guardian Information

Transportation

Name(s) & Number of Persons (other than parents) who are permitted to pick up your child/children.

Payment Options