Basketball Camp Registration Template

2026 INTEGRATIVE SPORTS WELLNESS EXPERIENCE

BASKETBLL SKILLS CAMP | FAITHBRIDGE INTEGRATIVE WELLNESS CAMP | WARDROBE WISDOM | VOLLEYBALL | 8 - PERSONAL HEALTH COACHING
Athlete Information
Name

First NameLast Name
Grade, Age
Gender
Buddy Referral Name (Faithbridge Integrative Wellness)

First NameLast Name
Grade, Age
Gender
Parent/Guardian Information
Name

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

First NameLast Name
Relationship
Phone Number
Format: (000) 000-0000.
Alternative Phone Number
Format: (000) 000-0000.
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 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

My Products

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Should be Empty:

2026 INTEGRATIVE SPORTS WELLNESS EXPERIENCE

Athlete Information

Parent/Guardian Information

Emergency Information

My Products