SUMMER BASKETBALL CAMP

Player Registration Form

Player Information

Player Name*

Date of Birth

Age

Grade

Gender

Boy

Girl

School

Parent / Guardian Information

Parent/Guardian Name*

Phone Number*

Email*

Address

Camp Information

Camp Location

Camp Dates / Session

Camp Time

Emergency Contact

Name

Relationship

Phone Number

Medical Information

Does your child have any medical conditions, allergies, or injuries?

✓

Yes — Please explain:

Is your child taking any medication?

✓

Yes — Please explain:

Skill Level

Beginner

Intermediate

Advanced

Elite

T-Shirt Size

Youth S

Youth M

Youth L

Adult S

Adult M

Adult L

Adult XL

Payment Information

Camp Fee ($)

Amount Paid ($)

Balance Due ($)

Payment Method

Cash

Cash App

Apple Pay

PayPal

Cash App: $RISINGSTARZATHL3T3S

Media Release

YES, I allow photos/videos of my child for promotional use.

NO, I do not allow media use.

Parent Consent

I give permission for my child to participate in Rising Starz Athletes Summer Basketball Camp and agree to all terms and conditions.