SVS Sports- East Stroudsburg Team Camp Form

SVS Sports- East Stroudsburg Team Camp Form

PAGE 1
SELECT TEAM CAMP LOCATION & DATES
CAMP TYPE
Please talk to your Head Coach to determine what option to select! All meals and lodging are included in resident camper rates.
School; Team Name
Player Name

First NameLast Name
Cell
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mother's Name

First NameLast Name
Mother's Phone
Please enter a valid phone number.Format: (000) 000-0000.
Father's Name

First NameLast Name
Father's Phone
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact

First NameLast Name
Emergency Phone
Please enter a valid phone number.Format: (000) 000-0000.
Player Weight
Height
Age
Grade
as of September 2026
Position
Head Coach Name

First NameLast Name

2026 SVS TEAM CAMP REGISTRATION FORM

PAGE 2
SVS Shirt Size
All Players will be provided with a complimentary SVS Team Camp Shirt.
CAMP PAYMENT: ALL MONEY ORDERS MADE PAYABLE TO JIM CANTAFIO

Important: If players are paying individually, they must provide payment in the form of a money order made payable to Jim Cantafio. Give this payment to your Head Coach. Your Coach will then mail in as a TEAM to: SVS, Inc. - 133 Bank Barn Lane, Lancaster, PA 17602

If players are paying their booster clubs, the booster club is then allowed to write a personal check payable to Jim Cantafio.
SECURITY DEPOSIT – TEAM CAMPS

Head Coach is required to submit a $250.00 security deposit per team. This deposit will be forfeited if any of the following occur:

-Damage to a dorm room, hallway, or bathroom facility on the assigned floor
-Pulling or tampering with a fire alarm on the assigned floor
-Dismissal from camp for disciplinary reasons
-Loss of a room key or combination card

If damages exceed the $250.00 team deposit, the camper and their parent/guardian will be billed for the balance. Important: if a fire alarm is pulled, the school will lose their deposit.

By registering, I understand and accept full responsibility for these conditions and acknowledge that I may lose my security deposit if any of the above occu
Date

MonthDayYear
Date
Signature

Signing: FOR MOUSE: Click and hold inside the "Sign Here" box, then drag to draw your signature FOR TOUCHSCREEN/TABLET: Use your finger or stylus to sign directly in the box; FOR TRACKPAD/LAPTOP: Click and hold while dragging your finger across the trackpad.
REFUND POLICY:

Underclassmen: No cash refunds will be issued. Underclassmen will receive a camp credit to be applied toward future SVS Sports camps.
Notification Requirement: To qualify for a credit or refund, written notification must be received by SVS Sports, Inc. at least one week prior to the start of camp. Failure to provide timely notice will result in no credit or refund being granted. No exceptions will be made.
Seniors: Cash refunds are available only to seniors. A $100.00 service charge will be deducted from the refund amount.
Refund Timing: All refund checks will be processed and mailed at the end of August.

Make all Money Orders payable to: Jim Cantafio

Have Questions? Call Coach Cantafio at (717) 468-7185

2026 SVS Medical Release Form

PAGE 3
Players Name

First NameLast Name
Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
School; Team Name
Mother's Name

First NameLast Name
Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Father's Name

First NameLast Name
Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
In the event that I am unavailable for the purpose of providing parental consent, I hereby authorize the physician(s) and staff at the local hospital to provide such care that routine diagnostic procedures and medical treatment as necessary to my minor son/daughter. I understand the consent and authorization herein granted do not include major surgical procedures and are only valid during camp.

This camp does not provide medical insurance for campers. In the event of illness or injury requiring treatment or hospitalization, family medical insurance must be used. Parents will be billed directly for any medical care given at the College Health Center or local hospital.
List any health conditions that a physician should be aware of:
Date of most recent tetanus immunization shot (if more than 10 yrs, booster is recommended.

MonthDayYear
Date
I understand that I will be contacted during the child's examination in the emergency department.
Emergency Contact:
Emergency Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Current Physician Name
Physician Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Do you currently have health insurance?
NO HEALTH INSURANCE; RELEASE OF LIABILITY

I certify that the above-named participant does not have health
insurance coverage at the time of registration.

I, the undersigned parent/guardian (or participant if 18 years of age
or older), hereby release and hold harmless SVS Sports, East
Stroudsburg University, and Millersville University, and their
respective staff, employees, agents, and volunteers from any and all
claims, liability, damages, or expenses arising from any injury,
illness, or medical condition sustained by the participant during any
SVS Sports camp or event, including but not limited to the cost of any
emergency medical treatment, transportation, or hospitalization.

I understand that:

No health insurance coverage will be provided by SVS Sports, East
Stroudsburg University, or Millersville University.
I am solely responsible for any and all medical expenses incurred by
the participant.
Participation in this camp/event involves physical activity and
inherent risk of injury.
This release is a condition of the participant's enrollment and participation.
Health Insurance Company
Policy Number
Policy Number
Group Number
Group Number
Primary Holder Of Insurance (Father/Mother)
Primary Holder Birthdate

MonthDayYear
Date
Primary Holder Place of Work
Parent/Guardian Name
Date

MonthDayYear
Date
Signature

Signing: FOR MOUSE: Click and hold inside the "Sign Here" box, then drag to draw your signature FOR TOUCHSCREEN/TABLET: Use your finger or stylus to sign directly in the box; FOR TRACKPAD/LAPTOP: Click and hold while dragging your finger across the trackpad.

SVS Team Camps Anti-Hazing Policy

PAGE 4
SVS Sports and Millersville/East Stroudsburg University are proud to uphold the values and qualities that support the development of our Team Camp participants.

Any form of Hazing is strictly prohibited by SVS Sports, Millersville University/ East Stroudsburg University camp policies and by PA law. Violation of the hazing policy may subject an individual or team to disciplinary action, by SVS Sports, University officials, respective school authorities with penalties up to and including dismissal for individuals and suspension or termination in the team’s future privilege of attending SVS Team Camps. In addition to incurring serious Camp-imposed consequences for violations of SVS Sports Camp and Millersville University/ East Stroudsburg University policies, students and team’s may be subject to criminal prosecution by legal authorities for violation of PA state hazing laws.

SVS Sports has adopted a broader definition similar to many PA based schools and colleges defining hazing as: Any activity that is part of an initiation, participation, or affiliation in a group that 1) physically or psychologically humiliates, degrades, abuses, or endangers--regardless of a person’s willingness to participate; 2) results in the disruption of the educational process or the impairment of academic performance; or 3) violates University policy or state law. This applies to behavior on or off campus.

Examples of hazing include but are not limited to the following:

Physical threats or abuse of any kind; encouraging or requiring a person to consume alcohol, drugs, or foreign or unusual substances; forcing a camper into a violation of the law or Camp policy such as indecent exposure, theft, or trespassing; confining a person or taking a person to an outlying area and dropping him/her off; servitude such as encouraging or requiring a person to run personal errands; requiring a shaved head or the wearing of conspicuous apparel in public; and depriving a person of sleep. Hazing has dangerous potential to harm individuals, to damage organizations and teams, and to undermine the mission of SVS Team Camps, Millersville University/East Stroudsburg University, individual schools and the fundamental values of our community. As such, no camper, camp employee, camp volunteer, team coach, or other camp-recognized individuals or groups shall conduct or condone hazing activities, consensual or not.
Date

MonthDayYear
Date
Signature

Signing: FOR MOUSE: Click and hold inside the "Sign Here" box, then drag to draw your signature FOR TOUCHSCREEN/TABLET: Use your finger or stylus to sign directly in the box; FOR TRACKPAD/LAPTOP: Click and hold while dragging your finger across the trackpad.

SVS Team Camps - Waiver & Assumption of Risk

PAGE 5
I certify that I am the parent or guardian of camper and voluntarily sign this waiver and assumption of risk in favor of Susquehanna Valley Sports Inc. ( the organization ) in consideration for any or all of the following:

1. The opportunity to use facilities owned, leased, or operated by the organization, and/or

2. The opportunity to receive instruction in an activity from the organization’s employees and/or volunteers, and/or

3. The opportunity to engage in the activities sponsored or conducted by the organization.

I fully understand that there are certain risks and dangers associated with the facilities, instructions, equipment and/or activities that cannot be eliminated regardless of the care taken to avoid injuries and that these risks and dangers have been fully explained to me. I fully understand the risks and dangers involved. I fully assume the risks and dangers involved as acceptable to me, and I agree to use my best judgment in undertaking these activities, and I agree to follow all safety instructions. I waive, release, covenant not to sue, and agree to indemnify and hold harmless Susquehanna Valley Sports Inc. and Jim Cantafio from any claims, actions, suits, costs, expenses, damages or liabilities, including attorney’s fees for personal injury, property damage, accidents, illnesses, death, or any incidental damage that may arise from my child’s use of the facilities or equipment or from participation in the activities or receipt of instruction.

I am a competent adult and I assume these risks of my free will. I have read this Waiver and Assumption of Risk and I understand its full terms. I understand that I am giving up substantial rights and I acknowledge that I intend by my signature that this be complete and unconditional release of liability to the greatest extent of the law.
Date

MonthDayYear
Date
Signature

Signing: FOR MOUSE: Click and hold inside the "Sign Here" box, then drag to draw your signature FOR TOUCHSCREEN/TABLET: Use your finger or stylus to sign directly in the box; FOR TRACKPAD/LAPTOP: Click and hold while dragging your finger across the trackpad.
Should be Empty:

SVS Sports- East Stroudsburg Team Camp Form

2026 SVS TEAM CAMP REGISTRATION FORM

2026 SVS Medical Release Form

SVS Team Camps Anti-Hazing Policy

SVS Team Camps - Waiver & Assumption of Risk