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| Please select which session(s) you would like to attend below prior to filling out the registration form. |
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To select multiple camps, hold down the ctrl key and select both sessions.
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Last Name (Parent/Guardian) First Name
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Address
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City St
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Zip
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Home Phone Cell Phone
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Email
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Participant Information
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Last Name (Child) First Name
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Age Birthday (mo/day/year)
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| School Name
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| Last Name (Child2) First Name |
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Age Birthday (mo/day/year)
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| School Name
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Last Name (Child3) First Name
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| Age Birthday (mo/day/year) |
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| School Name
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Check the box to agree to the following health statement: |
| I certify that the above named applicant is in good health and has my permission to participate in the program. I hereby release and forever discharge Future tars Basketball Academy, its coaches, agents and the owners of any fields used from all liability for any personal injury or illness, damage or loss incurred while articipating in this camp. I grant permission for my child to be given medical treatment as deemed appropriate to Future Stars Basketball Academy. There will be no refund of tuition, fees, charges, or other payments made to Future Stars Basketball Academy in the event the operation of Future Stars Basketball Academy is suspended at anytime as a result of any act of God, strike, riot, disruption or for any reason beyond the control of Future Stars Basketball Academy. |
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Insurance Information
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| Insurance Name Policy Number |
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Check the box to agree to the following insurance statement:: |
PARENT/GUARDIAN STATEMENT: I hereby authorize and request the Academy Director to secure the necessary medical care and treatment for my child should the need arise. My child is physically able to participate in all activities. If my child appears ill, I will keep him/her home. I have read the Academy brochure and understand and agree to cooperate with all regulations. I have read, understood, and executed the Future Stars of Basketball Academy Liability Release form. I will be responsible for all costs of medical treatment incurred by the Academy. I authorize Future Stars of Basketball Academy to use
photographs of my child for the purpose of Academy promotion and/or advertising. |
| Please make sure that you indicated which session(s) you would like to attend above before submitting. |
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