Basketball World Summer Camp Registration Page

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Hopewell Basketball Association

 Basketball World Summer Camp Registration Form

Please Print Below

Please Print Below
Name_______________________________________________________________

Address_____________________________________________________________

____________________________________________________________________

Phone # _____________________ Emergency phone or Cell #_________________

Email Address_____________________________________________________________

Age ____________ Grade __________Shirt Size _________Gender ___________

School __________________________________________ Height _____________

Parent/Guardian Name _________________________________________________

Please check box
□ "Basketball World Summer Camp

Late fee of $10 will be applied after June 14th, 2010 Refunds after April 5th will be minus $50 for administrative fees. No refunds will be given back after June 14th, 2010 doctors note us required.
I, the adult applicant, _________________________ Date _________________hereby give approval for the applicant’s participation in and any Hopewell Basketball program;
I will not hold the organization and sponsors, their employees and associated personal, including owner of fields and facilities utilized for the programs against any claim by or on behalf of the registrant as a result of the registrant ‘s participating in the program and/or being transported to or from the same, which transportation. I give permission to the Hopewell Basketball Association to use photographs of myself and /or my child for historical archives, educational, and promotional purposes. These materials may be used for immediate of future use. I understand that there is no remuneration and that the pictures will not be used for commercial purpose. . I certify that the applicant is in good health and may participate in physical activities associated with the camp's vigorous athletic programs, without limitation(s). The director of the camp has my permission to arrange for, and provide medical care in the event the applicant is injured or disabled. I understand that the camper must present to the camp director, before participation in camp, a medical certificate from a physician stating that the camper is physically fit to participate in camp activities.

To register, submit completed registration form with payment and sent it to Hopewell Basketball PO Box 613 Pennington NJ 08534
Mail to : Hopewell Basketball Association PO BOX 613 Pennington NJ 08534 Online Credit Card registration is available at www.hopewellbasketball.com