One Dream Tennis & Basketball Camp Registration Form

One Dream Tennis & Basketball Camp

Registration Form

(ages 8 to 12)

Cra-Z-Dreams Life Skills Development LLC

Child Information

Name*

First NameLast Name

Age*

Grade*

School Attending*

Parent/Guardian Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

City

Postal / Zip Code

Parent/Guardian Cell Phone*

Area CodePhone Number

Secondary Phone

Area CodePhone Number

Parent/Guardian E-mail*

**Pay by Debit or Credit Online** My Products

Tennis, Basketball, and Life Skills Camp$25.00

Enter coupon

Subtotal $0.00Tax $0.00Total $0.00

Desired Package - Pay by Phone (enter # sessions > 10 or discount codes under "Other"). Cra-Z-Dreams will contact you to confirm your order and process payment:

Platinum (10+ sessions) ---> $175+Gold (8 sessions) ---> $160Silver (6 sessions) ---> $135Bronze (4 sessions) ---> $100Platinum Additional Sessions (# sessions > 10) ---> $17.50One Day Intro Workshop (2 hours) ---> $50.00Other

Please enter any growth areas that should be points of focus for your child along with his/her strengths. If you registered for sports training please include experience, skill level and sports development information. (Send an email to info@cra-z-dreams.com with child's name if you run out of space)

Basketball skill level (based on child's age)

	1	2	3	4	5

1 is Beginner, 5 is Advanced

Tennis skill level (based on child's age)

	1	2	3	4	5

1 is Beginner, 5 is Advanced

Important Notes & Terms of Participation

· Dress appropriately (school appropriate athletic attire).

· Keep the classroom/practice area/facility clean.

· All registrants must participate in both tennis and basketball training as well as life skills lessons.

. No food or drinks in classroom/gym, but those might be sold outside of the classroom/gym for participants and others.

· Sports team/training organizers reserve the right to form the teams and/or training groups to ensure maximum benefit and growth of each player/participant.

· Be courteous and respectful to everyone we encounter.

. All members and parents are expected to demonstrate proper respect to teachers, coaches, special guests and other members/students. Cra-Z-Dreams reserves the right to release any member(s) for conduct by him/her or their parent(s) deemed inappropriate or detrimental to the program WITH NO REFUND. We are here to develop character and life skills for each child and maximize the growth of each individual.

Emergency Contact & Health Insurance Information

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Area CodePhone Number

Does the child you are registering have health insurance?

YesNo

Insurance Carrier

Name of Policy Holder

Subscriber ID

Group Number

Card Number / Card Date

Does the participating child have any allergies, chronic illness, or medical conditions?*

YesNo

Please describe*

Parental Permission For Emergency Treatment

In the event of illness or accident, I give my permission for emergency treatment by qualified medical personnel for my child, and I authorize the person in charge to take my child to:
I give consent for the facility to secure any and all necessary emergency medical care for my child.

Name of Physician / Emergency Medical Care Facility

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Area CodePhone Number

Release of Liability

Although the safety of all sport activities is the primary concern, indoor and outdoor sport activities may cause injuries and/or death. I expressly assume the risk of injury, death, and/or illness arising from any cause, and agree to waive the right to pursue any claim against Cra-Z-Dreams Life Skills Development LLC, One Serve Youth Tennis Academy, and the persons in charge.

I have read and agree to the above terms & conditions*

YesNo

Parent/Guardian's Signature*

Relationship to Child*