BBA D-1 Super Camp

* Required Fields
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You may register one or two (siblings) on this form.
Registration fee for one child is $100
Registration fee for the second child is $75
*CHOOSE PAYMENT OPTION
 Pay full amount one child (+$100.00)
 Pay full amount 2 children (+$175.00)
Participant #1 Registration 
*Player First Name
*Player Last Name
*Gender
*Current Age
*Rising ('19-'20) Grade
*Current School
*T-Shirt Size
Medical conditions? If so, please let us know.
Any food allergies? Please list all!
Second Child Registration
Player #2 First Name
Don't type in this field
Player #2 Last Name
Gender
Rising ('19-'20) Grade
Current School
T-Shirt Size
Medical conditions? If so, please let us know.
Any food allergies? Please list all!
Parent/Guardian Information
*Parent/Guardian #1: Name
*Email Address
*Cell #
Parent/Guardian #2 (Name)
Email Address
Cell #
Medical Release
As a parent or guardian of the above named player(s), I hereby give my consent for emergency medical care as prescribed by a doctor or dentist to my dependent. I, the parent or guardian, agree that my child and I will abide by the rules of the Birmingham Basketball Academy's/D-1's 2019 Super Camp. I furthermore hereby release, discharge, and or otherwise indemnify the league, administrators, & coaches against any claim by or on behalf of the registrant as a result of their injury in the program.
*Waiver Agreement
 
I have read and agree with the waiver. 
 
*Does your family have health insurance?
 Yes 
 No 
Total Due:
$ 
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