Registration Form

JR Pickleball Camp Registration Form

Please complete all sections below to register your child.
Camper Information
Camper's Full Name:

First NameLast Name
Camper's Age (as of June 1st , 2026):
Gender
Pickleball Skill Level
Parent/Guardian Information
Parent/Guardian Full Name

First NameLast Name
Primary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email Address
example@example.com
Emergency Contact
Emergency Contact Full Name

First NameLast Name
Relationship to Child
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Medical Information (Medical Release & Emergency Authorization)
Family Physician Full Name

First NameLast Name
Physician Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Medical Insurance Provider
Policy Number
Allergies, Medications, or Medical Conditions (State NA if none)
I authorize Jr Pickleball Camps staff, coaches, and representatives to obtain emergency medical treatment for my child in the event I cannot be reached immediately. I understand that every reasonable effort will be made to contact the parent/guardian or emergency contact before medical treatment is administered. I acknowledge that participation in sports activities may involve physical exertion and potential risk of injury.
Pickup Authorization
Authorized Pickup Person 1 Full Name

First NameLast Name
Relationship to Child (Pickup Person 1)
Phone Number (Pickup Person 1)
Please enter a valid phone number.Format: (000) 000-0000.
Authorized Pickup Person 2 Full Name

First NameLast Name
Relationship to Child (Pickup Person 2)
Phone Number (Pickup Person 2)
Please enter a valid phone number.Format: (000) 000-0000.
Authorized Pickup Person 3 Full Name

First NameLast Name
Relationship to Child (Pickup Person 3)
Phone Number (Pickup Person 3)
Please enter a valid phone number.Format: (000) 000-0000.
List any individuals NOT authorized to pick up your child
Liability Waiver
I, the undersigned parent/guardian, hereby release and hold harmless Jr Pickleball Camps, its staff, coaches, volunteers, and affiliates from any and all claims, damages, injuries, or losses arising out of my child's participation in camp activities. I acknowledge that pickleball and sports activities carry inherent risks and I voluntarily assume all such risks on behalf of my child. I grant permission for my child to participate in all camp activities and authorize the use of photographs/videos taken during camp for promotional purposes.
I have read, understand, and agree to the liability waiver and release
Parent Signature
Date

MonthDayYear
Date
ACE PICKLEBALL CLUB WAIVER
Ace Pickleball Liability Waiver — Required. You must complete the Ace Pickleball liability waiver separately by clicking the link below before your registration is considered complete.
Please also complete the Ace Waiver Form
I confirm that I have completed the Ace Pickleball Liability Waiver at the link above.
PAYMENT - Camp Deposit $103.20

A registration deposit is required to reserve your spot. Full payment will only be processed once camp enrollment is confirmed, helping families avoid unnecessary fees if minimum capacity is not reached.
Secure payment will be processed at checkout. Accepted payment methods: Credit/Debit Card (Stripe or Square).

Items

Camp Deposit - Credit Cards

There is a credit card fee associated with this payment option.

$103.20

Total

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

JR Pickleball Camp Registration Form

Camper Information

Parent/Guardian Information

Emergency Contact

Medical Information (Medical Release & Emergency Authorization)

Pickup Authorization

Liability Waiver

ACE PICKLEBALL CLUB WAIVER

PAYMENT - Camp Deposit $103.20

Items