MOBUCKETS DTX - Basketball Training Camp

MOBUCKETS DTX - BASKETBALL TRAINING CAMP

Registration Form
Thank you for your interest in signing up your child for our Basketball Camp. Please take a moment to fill out the form below. If you have multiple children between the ages of 8-18 you would like to enroll, please submit a separate form for each child.

**Please Note: Registration for this event is completely free, but parents must fill out this form for their child to participate.**
Participant Information
Athlete's Name*

First NameLast Name
Age*
Parent/Guardian Information
Name*

First NameLast Name
E-mail*
example@example.com
Cell Number*
Format: (000) 000-0000.
Emergency Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*
Format: (000) 000-0000.
Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities during the selected camp. I assume all risks and hazards incidental to the conduct of the activities, and release, absolve and hold harmless the coaches and affiliates. I release all its respective coaches, 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 affiliates of this camp, including all coaches, facilities, participants, 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. In case of any emergency 911 and parents will be called.
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
Should be Empty:

MOBUCKETS DTX - BASKETBALL TRAINING CAMP

Participant Information

Parent/Guardian Information

Emergency Information