Registration Form

Camp
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Details
Location
Preferred First Training Session (you will be contacted to confirm)
Player
Email Address *
Player's Name *	First Last
DOB *
Current Team
Position
Shoots
Primary Program
Payment
Amount	$
Payment Plan (payments are charged monthly on the same day as registration)
Promo Code
Payment Method	Visa Mastercard Discover American Express
Name on Card *	First Last
Card Number *
Expiration Date *
Billing Address
Address *
City *
State/Zip Code *	State Zip Code
Optional
Comments
Policies & Waivers
Your Child's health and Safety Your Child's Health and safety is a matter of importance to us. upon enrollment you must file with us a health form signed by a physician. We also require that the standard immunizations 9 to include HIB, TB and Chicken Pox/Varicella vaccine are up to date. Your child may be sent home if he/she appears to have symptoms of illness during the day. In such cases, he/she is immediately isolated from the other campers and a parent/guardian is contacted. You will be notified immediately and will need to make arrangements to pick up your child promptly if your child: Has a fever of 101 or over - Vomits - Has 3 incidents of diarrhea- Has symptoms of chicken pox- Has symptoms of strep throat - Has conjunctivitis ( pink eye). Please keep your child home if he/she: Has a fever or has had one during the previous 24 hours Has a heavy nasal discharge (green) Has symptoms of a possible communicable disease ( flu/cold symptoms, strep, chicken pox, diarrhea,etc.) Please notify the camp director if the child does have a communicable disease. Your child maybe come to camp if: cold is over but left with a minor nasal drip has been on medication for a minimum of 24 hours (3 doses). This shall include medication for conjunctivitis and strep throat. In case of injury every attempt will be made to contact the parent. If the parent/guardian cannot be reached, first aid will be provided. if necessary, an ambulance will be called. Until the arrival of a parent/guardian, the director will make all decisions about the care of your child. Be advised that the camp does provide a qualified Medical Director. The camp will maintain a signed consent for this provision. It is to your child's benefit to keep an up to date file on phone numbers and contacts. Digital Signature:

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