Summer Camp Detailed Registration Form

Summer Camp Registration

Ages 4-16
Choose Your Camp Week
Athlete's Name

First NameLast Name
Athlete Information
Birth Date

MonthDayYear
Grade
Gender

MaleFemale
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information
Name

First NameLast Name
Home Number
Cell Number
E-mail
example@example.com
Emergency Information
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? 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 Charming Athletics Allstars during the selected camp. In exchange for the acceptance of said child’s candidacy by Charming Athletics Allstars., I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Charmnig Athletics Allstars 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 Charming Athletics Allstars, 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.
Summer Camp Waiver and Release of Liability

I, the undersigned parent/legal guardian of the above listed child hereby give permission for my child to participate in the activities at Charming Athletics Allstars Summer Camp. I understand that participation involves physical activity and that there is a risk of injury.

By signing below, I agree to release, waive, discharge, and hold harmless Charming Athletics Allstars and its owners, staff, volunteers, and affiliates from any and all liability, claims, demands, or causes of action arising out of or related to any loss, damage, or injury that may be sustained by my child during camp activities, whether caused by negligence or otherwise.

I confirm that my child is physically able to participate and that I am signing this agreement voluntarily.
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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I am choosing week (choose week your child is attending below).

MonthDayYear
Date
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Summer Camp Registration

Athlete Information