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2019 Camp Registration Form

2019 Another Level Basketball Camp

Enrollment and Waiver Form.

After sending registration, you will then be taken to the payment page.

* SPECIAL NOTE: A separate form needs to be filled out for each player.

EARLY BIRD REGISTRATION COST: $99.00 per player. ($125.00 after May 28th, 2019

  • PLAYER INFORMATION

  • CONTACT INFORMATION

  • PARENTAL RELEASE

    Parental Release form for the “Another Level” Basketball Camp 6/10-13 2019

    BY FILLING OUT THE RELEASE FORM ONLINE, YOU AGREE THAT YOUR DRAWN SIGNATURE BELOW WILL ACT AS YOUR LEGALLY BINDING DIGITAL SIGNATURE.

  • **If you need to enroll more than one player, you will need to fill out another form, per player.
  • I the undersigned parent/guardian of the individual named above, a minor, has my permission to participate in the aforementioned activity (6/10-13 2019) and I authorize and appoint, in my absence, the program directors and/or instructors as Attorneys-in-Fact and agents for the undersigned to consent to medical, surgical and/or dental examinations, in addition to any and all other treatments that may be deemed necessary by medical personnel. I understand that participation in this camp involves an element of risk and a danger of accidents. Knowing these risks, I hereby assume responsibility and liability for any injury.  In addition, I understand that by signing this agreement, I hereby release and discharge Westside Hoops, Project Thrive, The County of Maui and all coaches/clinicians from any and all liability resulting in injury associated with my child’s participation in this camp. I understand it is my responsibility to inform camp personnel of any medical conditions, or any other special needs my son/daughter may have.  I grant my permission to photograph or video me/my dependent and use the photo and or other digital reproduction of me/him/her or other reproduction of me/his/her physical likeness for publication processes, whether electronic, print, digital or electronic publishing via the Internet.  My signature affirms that I accept that this camp also includes character skills development and daily biblical references. Signature (if under 18 must be signed by a parent or guardian)
  • Use your mouse or finger on touch pad devices and sign your name the best you can.
  • Office use only:

    Date Received__/__/__ Scholarship____ Check/CC#______ Amount Received__________ Split____ Confirmation sent____

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