Winchester Rising Stars Camp Registration

Athlete First Name *

Athlete Last Name *

Athlete Jersey Size

Athlete Age *

Athlete Grade (Rising)

Athlete Skill Level *

Parent 1 First Name *

Parent 1 Last Name *

Parent 1 Phone *

Parent 1 Email *

Parent 1 Address *

Parent 1 City *

Parent 1 State *

Parent 1 Zip *

Parent 2 First Name

Parent 2 Last Name

Parent 2 Phone

Parent 2 Email

Parent 2 Address

Parent 2 City

Parent 2 State

Parent 2 Zip

Emergency Contact (First and Last Name) *

Emergency Contact Phone *

Athlete Medical History

Please list below any medical information that our staff would need to take care of your athlete. Medications, injuries, food or medicine allergies, etc.

If none, please indicate

Athlete Medical Info *

Refund Policy

Due to demand, there is a $100 registration fee for the camp. If you are needing to cancel a registration, for any reason, before the start of camp, we will refund all fees paid above the $100 registration fee. No refunds will be issued after the start of a camp. Please check the box below if you agree to this policy. Your registration will not be submitted without agreeing to the refund policy.

Read and Accept Refund Policy? *

Yes

No

Winchester Rising Stars Camp Waiver of Liability

I hereby consent to the aforementioned person ("Athlete") participating in the Winchester Rising Stars Basketball Camp program including but not limited to; drills, stretching and games. I recognize that potentially severe injuries can occur in any activity that is associated with basketball and youth sports.I understand that this is the express intent of the Winchester Rising Stars, to provide for the safety and protection of my child and, in consideration for allowing my child to participate in the Winchester Rising Stars basketball camp, I hold Winchester Rising Stars totally harmless.

I hereby forever release Winchester Rising Stars and its Directors, Coaches, Trainers and staff, and/or facilities used by Winchester Rising Stars Basketball Camp, its officers, employees, coaches and owners from all liability for any and all damages and injuries suffered by my child while under the instruction, supervision or control of any of the above so mentioned. As legal guardian of the aforementioned person, I hereby agree to individually provide for the possible future medical expenses which may be incurred by my child as a result of any injury sustained while participating in the Winchester Rising Stars , and/or any facility used by the Winchester Rising Stars and its officers, employees, coaches and owners.

In case of an emergency, I authorize Winchester Rising Stars staff to administer first aid to my child/or take my child to a physician or hospital for further treatment. This acknowledgement of risk and waiver of liability, having been read thoroughly and understood completely, is signed voluntarily as to its content and intent.

YOU MUST AGREE TO WAIVER OF LIABILITY FOR YOUR ATHLETE TO PARTICIPATE IN CAMP

Read and Accept Waiver of Liability? *

Yes

No

Your initial camp fee is $200. Once you submit this form, we will send you a PayPal invoice to pay. Payment must be received to hold your spot for camp.