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Online Registration
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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 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)
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First Name
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Age Birthday (mo/day/year)
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Last Name (Child2)
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First Name
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Age Birthday (mo/day/year)
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Last Name (Child3)
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First Name
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Age Birthday (mo/day/year)
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Check the box to agree to the following health statement:
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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 Stars
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 participating 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
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Policy Number
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Check the box to agree to the following insurance statement::
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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.
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Please make sure that you indicated which session(s)
you would like to attend above before submitting.
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