2026 New Jersey Registration

Camper's Last Name

Camper's First Name

Gender

Address

City

State

Zip

Parent's First Name

Parent's Last Name

Email Address

Email Address 2

Primary Cell Phone One

For emergency useFormat: (000) 000-0000.

Secondary Cell Phone

For emergency useFormat: (000) 000-0000.

Grade in Fall '2027

Date of Birth

Age at the Beginning of Camp

Height

T-Shirt Size

School

EXCEL IN BASKETBALL CAMP

Participation & Medical Authorization: I give permission for my child to participate in Excel in Basketball Camp and represent that, to the best of my knowledge, my child is physically able to participate. I authorize Excel staff to provide or obtain reasonable first aid, emergency medical treatment, hospital care, or other medical assistance if necessary when I cannot be reached. I represent that my child has adequate medical insurance coverage, as identified below, and I accept responsibility for all medical expenses incurred in connection with my child's participation.

Assumption of Risk and Release of Liability: I understand that basketball and other camp activities involve inherent risks, including falls, collisions, physical contact, exertion, and other injuries associated with athletic activity. I knowingly assume these risks on behalf of my child. To the fullest extent permitted by law, I release and hold harmless Excel in Basketball and its officers, directors, employees, coaches, agents, representatives, and volunteers from claims arising from my child's participation, except to the extent such a release is prohibited by applicable law.

Photo/Media Release: As a condition of participation, I grant Excel in Basketball permission to photograph and/or record my child during camp activities and to use such photographs or recordings on its website, social media, email communications, printed materials, and current or future camp promotions. My child's name will not be identified without additional permission, and no compensation will be provided.

Acknowledgment and Electronic Signature: I acknowledge that I have read and understand this Participation Agreement, Medical Authorization, Assumption of Risk, Release of Liability, and Photo/Media Release. By completing the Signature Section below, I agree to these terms on behalf of myself and my child and agree that my typed name constitutes my electronic signature with the same force and effect as my handwritten signature.

Acknowledgment & Agreement

Parent/Legal Guardian Full Name

Camper's Name

Parent/Legal Guardian Electronic Signature (Type Full Name)

Date

Name of Company

Policy Number

Child's Physician

Please indicate "None," or identify any physical disabilities or medical conditions that may affect your child's participation at camp.

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New Jersey Registration and Payment

Medical Insurance Information