Waveffect Summer Fest
Basketball Registration Form
Participant Information
Participant's Full Name
*
First Name
Last Name
Gender
*
Please Select
Male
Female
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Age
*
Grade
*
Please Select
5th
6th
7th
8th
Participant's Full Name
First Name
Last Name
Gender
Please Select
Male
Female
Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Age
Grade
Please Select
3rd
4th
5th
Any previous basketball experience?
*
Parent Information
Parent/Guardian's Full Name
*
First Name
Last Name
Contact Email
*
example@example.com
Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact
Name
*
First Name
Last Name
Relationship
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Medical Information
Does your child have any medical conditions, allergies, or injuries we should know about?
*
Media Release
Type a question
*
I give permission for Waveffect Academy to photograph and/or video my child for promotional purposes.
Liability Waiver
Type a question
*
I understand participation involves physical activity and assume the risks associated with the clinic.
I authorize emergency medical treatment if necessary.
I understand my child is expected to follow the instructions of coaches and event staff.
Signature
Stay Connected
Would you like information about future Waveffect Academy programs?
Little Waves League
Waveffect Developmental League
Basketball Camps
Volunteer Opportunities
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