BASKETBALL CAMP REGISTRATION - SOLON HIGH SCHOOL
Please complete the form below.
Please verify that you are human
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Camp Location
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Solon High School - June 23-26 - 9 AM to 3 PM
Parent/Guardian Name
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First Name
Last Name
Parent/Guardian Email
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example@example.com
Daytime Phone
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-
Area Code
Phone Number
Best way to reach:
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Please Select
Phone
Email
Both
Emergency Contact: In the case that we cannot reach you, who would you like us to contact?
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First Name
Last Name
Emergency Contact Phone
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-
Area Code
Phone Number
Relationship to Camper
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Please Select
Parent
Grandparent
Aunt/Uncle
Sibling
Family Friend
Camper's Full Name
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First Name
Last Name
Camper's Age
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Camper's Grade
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Please Select
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Shirt Size (Youth)
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Male S
Male M
Male L
Male XL
Male XXL
Female S
Female M
Female L
Female XL
Female XXL
Camper's School
Lewis Elementary School
Parkside Elementary School
Roxbury Elementary School
Orchard Middle School
Solon Middle School
Solon High School
St. Rita's
Hathaway Brown
University Schools
Laurel
Solon Academy
Gilmour Academy
Other
Does your child have any medical conditions? (select all that apply)
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None
Asthma
Diabetes (Type 1 or Type 2)
Epilepsy / Seizure Disorder
ADHD (Attention-Deficit/Hyperactivity Disorder)
Autism Spectrum Disorder
Cystic Fibrosis
Congenital Heart Disease
Sickle Cell Disease
Muscular Dystrophy
Cerebral Palsy
Down Syndrome
Crohn’s Disease / Ulcerative Colitis
Celiac Disease
Thyroid Disorders
Hemophilia
Migraines
Anxiety or Depression
Other
Has your child had any recent surgeries, hospitalizations, or injuries?
No
Other
Does your child have any known allergies (e.g., food, medication, insect stings, environmental)? Select all that apply.
None
Peanuts
Tree nuts (e.g., almonds, walnuts, cashews)
Milk / Dairy
Eggs
Wheat / Gluten
Soy
Fish (e.g., salmon, tuna)
Shellfish (e.g., shrimp, crab, lobster)
Bee / insect stings
Pollen (trees, grasses, weeds)
Mold
Pet dander (cats, dogs, etc.)
Latex
Dyes or preservatives in food
Other
Is your child prescribed an EpiPen or other emergency medication?
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Please Select
Yes
No
If Yes, please specify below.
Please add any additional information (medical, etc.) that you would like us to know about your child. If there is nothing else, simply leave the box blank or put N/A.
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Would you like to purchase a lunch for your child (lunch will be an uncrustable sandwich, chocolate milk, and fruit (e.g., banana, orange, apple))?
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Please Select
No - $0
Yes - $20 extra
Will you be attending the award ceremony on the last day?
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Please Select
Yes
No
Maybe
By checking this box you agree with our refund policy: In order to receive a refund, your written cancellation notice must be received 48 hours in advance of the start of the camp.
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I agree
By checking this box you agree: I, the undersigned, hereby certify that I am the parent or legal guardian of the camper named above. During the period of the camp, I hereby give permission for the camp, staff, and volunteers to seek appropriate medical attention for my child, for the medical attention to be given to my child, and for my child to receive the medical attention in the event of an accident, injury or illness. I shall be responsible for any and all cost of medical attention and treatment. I, the undersigned, understand that basketball (sport) is an active, physical sport and that injuries may often occur during my child's participation at camp. I also understand that there will be more campers than staff and volunteers at the camp, and that my child cannot receive individualized attention and individualized supervision at all times. I hereby acknowledge that my child is physically fit and mentally capable of participating in drills, games, and all camp activities. I, the undersigned, hereby acknowledge and understand that Direction Up Basketball Camp is a privately run sports camp. The camp is neither sponsored, controlled, nor supervised by any organization, but rather is under the sole sponsorship, control, and supervision of Direction Up Basketball Camp LLC. I waive, release, and forever discharge Direction Up Basketball Camp LLC and the aforementioned staffs, volunteers, officers, agents, employees, representatives, successors, and assigns from any and all liability claims, demands, actions, and cause of action whatsoever arising out of or relating to any loss, personal injury, or property damage that may be sustained or occur during the participation in camp activities or while at camp. I give permission for "Direction Up Basketball Camp" to take photographs of my child while engaged in camp activities for the sole purpose of advertising and publicity, and I understand that my child's identity will remain anonymous in conjunction with any photographs used in marketing, furthermore, I hereby release any right to compensation during the use of any photographs. By checking, I agree below indicates that I have provided true information and have read, understand and agree to all statements on this entire form and on any other form required by the camp.
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I agree
Camp Registration Payment
Payment Type
Please Select
Check
Debit/Credit/PayPal
I'll be paying by check. (Make check out to Direction Up Basketball LLC and send to PO Box 39026, Solon, OH 44139).
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Camp Only ($250)
Camp + Lunch ($270)
By checking this box, I acknowledge that if my check is not received by the first day of camp, my child will not be able to participate.
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I agree
My Products
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BASKETBALL CAMP - SOLON
$260.00
$
260.00
(a $10.00 processing fee was added)
BASKETBALL CAMP - SOLON (with Lunch)
$280.00
$
280.00
(a $10.00 processing fee was added)
Total
$0.00
$
0.00
Payment Methods
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