Parent/Guardian Verification
I verify that the camper(s) listed below will be attending the Mama Blair Basketball Camp on the following dates: Fri, July 24 | 1-5pm AND Sat., July 25 | 9am-4pm
I understand that:
1) A snack will be provided on Friday. 2) Lunch and a snack will be provided on Saturday. 3) There is no cost to attend the camp. 4) I am responsible for transportation to and from Pueblo High School (3500 S 12th Ave, Tucson, AZ 85713.
Questions?
camp@mamablairbasketball.com
Camper 1
Camper Name
First Name
Last Name
Age
T-Shirt Size
Allergies/Medical Information
Emergency Contact Name
First Name
Last Name
Emergency Contact Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Camper 2 (if applicable)
Camper Name
First Name
Last Name
Age
T-Shirt Size
Allergies/Medical Information
Emergency Contact Name
First Name
Last Name
Emergency Contact Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Camper 3 (if applicable)
Camper Name
First Name
Last Name
Age
T-Shirt Size
Allergies/Medical Information
Emergency Contact Name
First Name
Last Name
Emergency Contact Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Camper 4 (if applicable)
Camper Name
First Name
Last Name
Age
T-Shirt Size
Allergies/Medical Information
Emergency Contact Name
First Name
Last Name
Emergency Contact Phone
Please enter a valid phone number.
Format: (000) 000-0000.
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Parent/Guardian Name
First Name
Last Name
Parent/Guardian Email
example@example.com
Parent/Guardian Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Liability Waiver & Release
By submitting this verification form, I acknowledge that participation in the SPL Sports Mama Blair Basketball Camp is voluntary and involves inherent risks of injury. On behalf of myself and my child(ren), I voluntarily assume all such risks and agree to release and hold harmless SPL Sports, Pueblo High School, Tucson Unified School District (TUSD), Joseph Blair, and their employees, volunteers, coaches, agents, and affiliates from any and all claims or liability arising out of or related to participation in the camp, except as prohibited by applicable law.
I have read and agree to the Liability Waiver & Release
*
Yes
Concussion Education & Acknowledgment
SPL Sports and the Mama Blair Basketball Camp are committed to providing a safe environment for all participants. We encourage athletes, parents/guardians, coaches, and volunteers to understand the signs and symptoms of concussion and the importance of reporting all suspected head injuries immediately. By registering my child for camp, I acknowledge that I have received and understand information regarding concussion awareness, including: 1) The importance of preventing head injuries whenever possible through safe play and good sportsmanship. 2) The signs and symptoms of a concussion, which may include headache, dizziness, confusion, nausea, sensitivity to light or noise, balance problems, or changes in behavior. 3) The potential short- and long-term consequences of returning to physical activity too soon after a concussion. 4) The importance of immediately reporting any suspected concussion or head injury to camp staff. 5) That any camper suspected of having sustained a concussion or other head injury may be removed from participation for the remainder of the activity and may not return until cleared in accordance with applicable medical guidance and camp policies. I understand that if my child experiences or is suspected of experiencing a concussion during camp, I will be notified as soon as reasonably possible.
I have read and understand the Concussion Education & Acknowledgment
*
Yes
Photo & Media Release
I grant permission to SPL Sports and the Mama Blair Basketball Camp to photograph, video record, or otherwise capture images or recordings of my child during camp activities. I understand that these images or recordings may be used without compensation for educational, promotional, fundraising, and marketing purposes, including but not limited to printed materials, websites, social media, newsletters, and other communications related to SPL Sports and the Mama Blair Basketball Camp. I understand that no identifying personal information other than my child's first name may be used without additional permission.
I grant permission for my child to be photographed and/or recorded for the purposes described above
*
Yes
Submit
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