D4G Summer Camp Registration  
2024
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Email *
Permission to Email (Stay connected) *
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Camp Selection *
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Child Name *
Age *
Date of Birth *
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Gender *
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Heath Issues (if Applicable) *
Home Address *
Home Phone
Cell Phone *
Permission to Text (Get the latest updates) *
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How did you hear about the Destined For Greatness *
School *
Grade *
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Skill Level: *
Please select the level that best describes your child.
Emergency Contact Name *
Emergency Contact Number *
Relationship to child *

RISK AND WAIVER OF LIABILITY

As legal guardian of                                                                                                               , I hereby give permission for the aforementioned person to participate in Destined For Greatness Basketball Club (D4GB) programs, tryouts, practices and/or games. I am aware that potentially serious injuries can occur in any basketball-related activity. I understand that it is the D4GB Club's express interest to provide for my child's safety and protection in exchange for allowing my child to play for the Destined For Greatness Basketball Club. I hereby forever release the Destined For Greatness Basketball Club, AAU Boys & Girls Basketball, ST. Louis Catholic, Reicher Catholic High School, and/or any facility used by the Destined For Greatness Basketball Club, its officers, employees, coaches and owners from all liability for any and all damages and injuries sustained by my child while under the instruction, supervision, or control of any of the foregoing. As the aforementioned person's legal guardian, I hereby agree to individually provide for any future medical expenses incurred by my child as a result of any injury sustained while training, practicing, competing, or trying out for the Destined For Greatness Basketball Club, AAU Boys & Girls Basketball,  St. Louis Catholic, Reicher Catholic High School, and/or any facility used by the Destined For Greatness  Basketball Club, its officers, employees, coaches and owners. In the event of an emergency, I authorize Destined For Greatness Basketball Club staff to administer first aid to my child and/or transport my child to a physician or hospital for further treatment. This acknowledgment of risk and waiver of liability is signed voluntarily as to its content and intent, having been thoroughly read and understood.

Destined For Greatness Media Consent
I _______________________, hereby give consent to Destined For Greatness Basketball, Its Coaches, and /or team managers to release and/or display the following regards to my child.
If I do not agree to the following, I will notify Destined For Greatness Basketball in writing, specifically stating my requests regarding photographic and/or video images, and/or listing my child's name on The Destined For Greatness Basketball website, www.d4gb.net
 
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