*First Name *Last Name

*Address *City *State * Zip

*Age *Gender Male Female

Phones * (1 phone is required)
Day Evening

Parent or Guardian Email

CAMP DATES:
July 6, 2021 - July 30, 2021
$65.00 Non-Refundable Registration Fee
Click here to Pay Registration fee on-line!!!

Special Pricing for:
Multiple kids in the same house & fees paid in advance.
Contact Coach D. for more information 678-508-3434

Make all check (s) & Money Orders Payable to:
Camp of Champions, Inc.

As parent / legal guardian of

I hereby give my approval for his/her participation in any activities of the Camp of Champions, Inc. Basketball Camp, held at Camp Site:

and authorize staff persons of the Camp of Champions, Inc. to provide guardianship for him/her while participating in Camp of Champions activities.
I assume all risks and hazards incidental to such participation, including transportation to and from the activities, and do hereby waive, release, absolve, indemnify and agree to hold harmless the Camp of Champions, Inc., the organizers, sponsors, supervisors, participants, staff persons, and person transporting my child to or from activities, for any claim arising out of injury to my child.

I agree to pay the Camp of Champions, Inc a late fee in cash upon pick-up if pick-up is made after 6:15pm ET.
At 6:16pm ET a fee of $5.00 is required and $1.00 for each additional minute beyond 6:16pm ET.

Parent / Guardian's Signature: _______________________________________ Date: _______________

Please complete the form, print, sign, date and mail to the following address with your check.

Camp of Champions
P.O. Box 361531
Decatur, GA 30036-1531

Print the form prior to Submitting