2019 Marauder Basketball Camp

MARAUDER BASKETBALL CAMP REGISTRATION

www.MarauderBasketballCamp.com

Participant Information

First Name *

Last Name *

Gender *

Birth Date * +

Grade Entering in Fall *

School *

Which week(s) of camp is your child attending? *

June 10th - 14th

June 24th - 28th

Both Weeks (June 10-14 & June 24-28)

Parent/Guardian Primary Contact

Relationship to Participant: *

Mother

Father

Guardian

Other Other

First Name *

Last Name *

Email Address *

Address 1 *

Address 2

City *

State *

Zip *

Phone *

Alternate Phone

WAIVER: I hereby authorize the staff of Marauder Basketball Camp to act for me according to their best judgment in any emergency requiring medical attention for my child, if I cannot be contacted. In consideration of acceptance of my child, I hereby for myself, my child, theirs heirs, executors and administrators hold harmless, waive and release any claim we may have for damages against Marauader Basketball, LLC, camp operators, their officials, officers, employers or representatives, or their successors and assigns for any and all injuries that may be suffered. I certify that I am parent/guardian of above participant and I am over the age of 18 years. I attest that my child is in sound physical/mental condition to participate in all activities. I understand by signing this waiver any or all refunds will come in the form of camp credit. SIGN BELOW: * *

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