Summer Camp Basketball Registration Registration Fee $125 Online / $135 at Door Camp Dates: 6/10/24 – 6/12/24Registration Deadline is June 9thSummer Camp Basketball Registration Fee(Required) Price: Parent / Guardian InformationParent / Guardian(Required) First Last Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone(Required)Email(Required) Enter Email Confirm Email Player InformationPlayer's Name(Required) First Last Player's Age(Required)Player's Grade(Required)Player's School(Required) Player's T-shirt Size(Required)Youth SmallYouth MediumYouth LargeYouth X-LargeAdult X-SmallAdult SmallAdult MediumAdult LargeAdult X-LargeInsurance InformationInsurance Company Name(Required) Member #(Required)Group #(Required)Emergency Contact InformationEmergency Contact Name(Required) First Last Phone Number(Required)General Release, Waiver of Liability & Hold Harmless Agreement That (Parent/Guardian) hereby agrees to indemnify and hold harmless the Hiram Youth Basketball Association, HBBC Board of Directors, Hiram HS and the Paulding County School District against any and all liability, loss, damages, costs, rights and causes of action of whatsoever kind and nature, specifically including, but not limited to, bodily and personal injuries of the undersigned or (Player Name #1,2,3) as their minor child, as well as all hospital bills, doctor bills, drug bills, and other medical expense, general and punitive damages, that may result from any incident occurring while en route to or from, or while on the premises of the facilities used by Hiram Booster Basketball Club. It is expressly agreed that the undersigned fully understands that the execution of this document will prevent the undersigned or (Player Name #1,2,3) their minor child, from asserting any claim as set forth herein, sustained while on the premises or en route to or from said premises. I hereby give permission for my child to obtain medical care by medical professionals. Additionally, I give permission for transportation to a medical care facility if required.Parent / Guardian Consent(Required) I agree with and consent to all terms Date(Required) MM slash DD slash YYYY Payments After filling out all required information and clicking the SUBMIT button, you will be redirected to PayPal to complete your registration.Total
