Lady Bears Youth Basketball Camp 2022 Registration

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Email *

Athlete's First Name *

Athlete's Last Name *

Grade Entering in 2022 *

T-shirt Size (size only guaranteed for registrations entered before June 1, 2022 - sizes shown currently are only options left in stock) *

Parent/Guardian Name *

Phone Number During Camp (9:00 am - 3:00 pm) *

Secondary Phone Number During Camp (9:00 am - 3:00 pm)

Health Insurance Company *

Policy Number *

Any medical conditions/allergies/etc:

Waiver: By clicking below I waive and release the staff and school district from any liability for injury and illness during camp. I also acknowledge that my daughter has no known physical impairment which would affect his participation in this camp. I realize that I am responsible for insurance coverage for my child. *

I Agree

Required

Payment has been submitted via: *

Venmo Troy Sweisfort (@tsweisfort) - please add child's name in comments

Mail - Check Payable to Troy Sweisfort, 47 Stacy Drive, Barto, PA 19504

A copy of your responses will be emailed to the address you provided.

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