Basketball Camp Registration Form

Fall Basketball Camp

The Primetime Ballers AAU Youth Basketball Club
Athlete Information
Athlete's Name*

First NameLast Name
Age*
Grade*
Gender*

MaleFemale
Parent/Guardian Information
Name*

First NameLast Name
E-mail*
example@example.com
Cell Number*
Planning to attend*

Both Days (9/16 and 9/18) $50.00Tuesday (9/16) Dribbling $30.00Thursday (9/18) Shooting $30.00
Payment Options*

Venmo: (www.venmo.com/primetimeballers)Apple Pay: 619.857.6681Check/money order payable to Primetime BallersCash Payment in an envelope with child's name on the outside,
Permission and Liability Waiver

    As the parent or legal guardian of the above-named player, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb, or well-being of my child.

   I agree to hold the Primetime Ballers harmless for any injury that may result from activities in the Fall Camp. I, the parent assumes all risks and hazards incidental to the conduct of the Primetime Ballers Fall Camp activities.

   I also give my permission for the Primetime Ballers Basketball Program to publish, copyright, or use all films and photographs in which my child is included for any exhibitions, displays, web pages and publications without reservation or compensation.
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*

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Fall Basketball Camp

Athlete Information

Parent/Guardian Information