DAY CAMP S2 SIGN UP

*PLEASE COMPLETE STEP 1 TO REGISTER CAMPER

*PLEASE COMPLETE STEP 2 TO FINALIZE CAMPER SIGN-UP & CHECK-OUT

STEP 1 - DAY CAMP SESSION 2 REGISTRATION

* Indicates required field

DAY CAMP SESSION *

SESSION 2 (GRADES 3-5)

CAMPER NAME *

First

Last

GRADE (FALL 2019) *

AGE *

SCHOOL DISTRICT *

PARENT/GUARDIAN *

First

Last

Phone Number *

PARENT/GUARDIAN *

First

Last

Phone Number *

Email *

*IF OTHER PLEASE DESCRIBE *

CURRENT MEDICATIONS *

PHYSICIAN'S NAME *

First

Last

PHYSICIAN'S Phone Number *

INSURANCE COMPANY *

GROUP # *

POLICY # *

In the event of an injury, illness, and/or accident involving my child, I hereby give my consent for medical treatment and permission to a first responder to supervise on-site first aid, to the appropriate camp personnel to properly transport my child to an appropriate medical facility for care, and to a licensed physician to hospitalize and secure proper treatment (including injections, diagnostic procedures, anesthesia, surgery, and/or other reasonable and necessary procedures) for my child. I agree to assume any and all costs related to such treatment. I also authorize the disclosure of medical information to my insurance company for the purpose of any claim. I understand that each participant must provide his/her own medical insurance in order to participate in aforementioned participant's attendance and participation in the Hope College Camps Program. I also understand that registration is not considered complete until this completed form is on file.

I certify that my child has no injury or illness which could jeopardize his well-being by participating in the basketball activities of the Hope Basketball Camp.

PARENT/GUARDIAN CONSENT *

AGREE

I agree to receiving marketing and promotional materials

Submit

*PLEASE DO NOT REFRESH PAGE AFTER SUBMITTING REGISTRATION

*PLEASE COMPLETE STEP 2 TO CHECK-OUT

STEP 2 - CHECK OUT

DAY CAMP SESSION 2 GRADES 3-5

$150.00

CHECK-OUT

QUESTIONS?

STEP 1 - DAY CAMP SESSION 2 REGISTRATION

STEP 2 - CHECK OUT

DAY CAMP SESSION 2 GRADES 3-5

Hope Men's Basketball Camps are independently owned and operated and the Hope College brand is being used by permission.