Hoops For Kids Registration
This registration form is for one child at a time, if you would like to register multiple kids, please complete the form multiple times.
What's your child's name?
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Age
*
Gender
*
Male
Female
Shirt Size
*
select size
small
medium
large
X-Large
XX -Large
What grade did your child just complete?
*
select grade
3rd
4th
5th
6th
7th
8th
Parent or Guardian's name?
*
First Name
Last Name
Emergency Contact info:
*
Which camp are you signing up for?
*
select one
Northbrook HS Camp June 18-19-20
Yates HS Camp July 9-10-11
Email
*
example@example.com
Is there anyone specific you would like to have on their team?
Medical History?
Media Release... I hereby grant permission for my child's photographs to be included in the newsletters, brochures and website related to the Hoops for Kids camp.
*
yes
no
Liability Release and Medical Authorization ... *I agree to abide by all the policies and procedures of said Hoops For Kids. I assume all the risk and responsibility due to bodily injury and/or damage of equipment as I involve myself in activities within Hoops for Kids. I hereby release Hoops for Kids and all persons acting on its behalf from any and all claims, actions, course of action and whatsoever kind of nature arsing from or by reason of any injuries and the consequences thereof incurred at the Hoops for Kids Basketball Camp. Furthermore, in the event of any injury, I hereby authorize the Hoops for Kids staff to administer necessary first aid.
*
i accept
i do not accept
My Products
*
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Register Your Child
$
25.00
Sponsor A Child
$
25.00
Quantity
Total
$
0.00
Submit
Print Form
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