Commit Compete Basketball Registration Directions

Boys Camp

  1. Please mail the following items to Commit Compete Basketball at 10 Patricia RoadMansfield, MA02048
  2. Completed Registration/Waiver Forms Below
  3. Check or Cash for the amount of $250, checks can be made payable to Commit Compete Basketball.
  4. Updated physical and most recent immunizations within the past year.

Note: If any of the above items are missing for registration, the camper will not be eligible to participate in camp/clinic activities

(scroll down to complete registration forms)

Commit Compete Basketball

August 6th-10th

REGISTRATION FORM

PARTICIPANT INFORMATIONPlease type or print legibly.

Last Name: First Name: ______

Gender:  Female  Male Age: _ T-Shirt Size______

Session:  Boys Camp

Grade Entering:

Home address:

City: State/Province: Postal/Zip Code:

Country: Telephone: cell:

Parent email:

(Include area code with telephone)

Mother’s name: Father’s name:

Mother’s day phone: Father’s day phone:

Mother’s cell:Father’s cell:______

Person’s Authorized to pick up child: ______

Other Dismissal Arrangements: ______

Emergency contact*: Relationship: Phone:

Specify any of your child’s health problems:

Is your child on any medication? No Yes If so, please specify:

Lunch: Please be sure that your child’s lunch is clearlymarked with your child’s first and last name. Glass bottles/containers are not allowed.

Payments: Tuition may be paid by cash or by check.

Make the check payable to: Commit Compete Basketball

CampFees:

  • Boys Camp: $250 if mailed prior to August 6th/ $275 for same day walk-in registration

REQUIRES PARENT’S SIGNATURE:

You have our permission, in the event of an emergency and in case we are unavailable, to authorize any physician, nurse practitioner or medical personnel to examine, interview, test and if necessary, treat my child (campers name)______as they may deem advisable.

Parent/Legal guardian name______Date______

Parent/Legal guardian Signature______Date______

Student Allergies______

Student Medical Problems______

PARENT STATEMENT

I hereby state that (camper’s name) ______is in good mental and physical health condition to participate in the activities provided by Commit Compete Basketball, including but not limited to all aspects of basketball, and or competition. I am fully aware that any activity involving motion or athletic activity creates the possibility of serious injury. I hereby release Commit Compete Basketball from liability to the above named athlete, of the person claiming through him/her, arising from injury to the person or property of the above named athlete occurring in the premises of Commit Compete Basketball.

I understand that Commit Compete Basketball has the right to deny admittance to any student not meeting the standards of the program as it sees fit. I also agree not to hold these parties responsible in the event that my son/daughter/child engages in inappropriate conduct (including, but not limited to disruptive or volatile behavior in or out of camp, etc.) or becomes involved in any activity or with any persons not associated with Commit Compete Basketball or its scheduled program and that Commit Compete Basketball has the right to send him/her home for inappropriate conduct. I further attest that the information contained in this application is correct to the best of my knowledge. In addition, I have agreed to the policy and fee statement and agree to comply.

Parent Signature______Date______