Put me on the list…
Please make sure to include
check or money order!
Please select camp date, and
type or write your information in the spaces provided and print.
Last Name: First Name: Male Female
Address:
City: State: Zip Code:
Check Shirt
Size: Youth: Adult: S
M L
X
School: Current
Grade:
Home Phone: Work (Day) Phone:
Cell Phone:
E-mail Address:
Emergency/Medical Information
Medical
conditions we should be aware of:
Incase of
emergency, call: (Other than
parent/guardian)
Name: Phone Number:
Parent’s
release and indemnity agreement to “Go For It” Basketball Camps
In
consideration of the acceptance of this application for enrollment in the “Go
For It” Basketball Camps, I/we, intending to be legally bound, hereby for
myself, my heirs, executors and administrators, waive and release any and all
rights and claims for damages I may have against Joe Townsell,
Bret Van De Pol, Sports University, and all sponsors
and all employees of the “Go For It” Basketball Camps for any or all damages
which may be sustained and suffered by me in connection with my/our association
with, or entry into this camp, and which may arise out of my traveling to,
participating, or returning from the camp.
I/We hereby grant permission for my/our child to be a participant in the
“Go For It” Basketball Camps. And if an
injury should occur during traveling to or returning from the camp, I/we agree
to pay for all costs present and future, through my/our medical insurance
policy and/or personal finances. I give
“Go For It” Basketball Camps permission to post on
their web address, pictures of my child participating in camp activities,
excluding names and/or addresses, for the purpose of advertisement and as a
service offered to parents.
Parent/Guardian Signature Date
Please return
(with fees!) to:
“Go For It”
Basketball Camps
Grimes, IA
50111