Raider Roundball Basketball Camp Registration
Please complete this form to secure your spot in our youth camp. The camp will take place June 14 - June 17 North Gymnasium. Boys entering grades 4-6 from 9:00-11:30a.m. and Boys entering grades 7-9 from 1:00-3:30p.m.

Please bring your own water or Gatorade.

The cost of the camp is $60 and can be paid upon check in on June 14th

Cash accepted or checks can be made payable to Shaker Basketball.
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Email *
Camper's Last Name *
Camper's First name *
Campers grade entering 2021/2022 school year *
Parent/Guardians Last Name *
Parent/Guardians First Name *
Parent/Guardians Email Address *
Emergency Contact Phone Number *
Camper Medical Concerns - Relevant info to assist staff, food & medical allergies, medications *
Youth t-shirt size *
Liability Waiver: I am aware that participation in the Raider Roundball Camp Program has some inherent risks and injury can occur. On rare occasions these injuries can be serious. In consideration of my child being allowed to participate in the Raider Roundball Camp Program, I, the parent/caregiver, assume the risk of all injury, including Covid 19 and agree not to sue Raider Roundball Camp Program, camp directors, coaches, assistant coaches, agents, or volunteers for any and all injuries caused by or resulting from participating in the Raider Roundball Camp Program. By signing this waiver, I also authorize the use of pictures of the above-named participant to be posted by the Raider Roundball Camp Program website, social media or advertising media published by Raider Roundball Camp Program. *
COVID-19 WAIVER OF LIABILITY and INDEMNIFICATION: I agree that I am personally responsible for my safety and actions of my child while using the facilities at Shaker Heights City School District. I agree to comply with all OHSAA and the Ohio Department of Health policies and rules, including but not limited to all Shaker Heights City School District policies, guidelines, signage, and instructions. Because Shaker Heights City School District is open for use by other individuals, I recognize that I am at higher risk of contracting COVID-19. With full awareness and appreciation of the risks involved, I, for myself and on behalf of my family, spouse, estate, heirs, executors, administrators, assigns, and personal representatives, hereby forever release, waive, discharge, and covenant not to sue Shaker Heights City School District, its board members, administrators, Athletic Directors, coaches, employees, agents and volunteers (collectively the “Released Parties”) from any and all liability, claims, demands, actions, and causes of action whatsoever, directly or in-directly arising out of or related to any loss, damage, or injury, including death, that may be sustained by me related to COVID-19 whether caused by the negligence of the Released Parties, any third-party using Shaker Heights City School District, or otherwise, while participating in any activity while in, on, or around Shaker Heights City School District and/or while using any SHCSD facilities, tools, equipment, or materials.                                                          I agree to indemnify, defend, and hold harmless the Released Parties from and against any and all costs, expenses, dam-ages, claims, lawsuits, judgments, losses, and/or liabilities (including attorney fees) arising either directly or indirectly from or related to any and all claims made by me, my family, spouse, estate, heirs, executors, administrators, assigns, and personal representatives against any of the Released Parties due to bodily injury, death, loss of use, monetary loss, or any other injury from or related to my interaction with SHCSD staff and/or use of the SHCSD facilities, tools, equipment, or materials, whether caused by the Released Parties or otherwise specifically related to COVID-19.                                                                                 By signing below I acknowledge and represent that I have read the foregoing Waiver of Liability, understand it and sign it voluntarily as my own free act and deed, including without limitation the Release of Liability and Indemnification requirements contained in this document; I am sufficiently informed about the risks involved in using the SHCSD to decide whether to sign this document; no oral representations, statements, or inducements, apart from the foregoing written agreement, have been made; I am at least eighteen (18) years of age and fully competent and am legally capable of execution of this release and waiver on behalf of the minor child named below; and I execute this document for full, adequate, and complete consideration fully intending to be bound by the same. I agree that this Waiver of Liability shall be governed by and construed in accordance with Ohio law, and that if any of the provisions hereof are found to be unenforceable, the remainder shall be enforced as fully as possible and the unenforceable provision (s) shall be deemed modified to the limited extent required to permit enforcement of the Waiver of Liability as a whole. This waiver remains in effect regardless of whether the State of Ohio lifts all COVID-19 related mandates. *
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