Crossover Basketball Camp

Crossover Basketball Camp 2023

• Crossover Basketball Camp*
  >Junior Camp (July 10-14)
• Camper Name*
  First Name

  Last Name
• Gender*
  >MaleFemale
• Age*
  >67891011121314151617
• Grade (September 2023)*
  >1234567891011
• Camper Health Card Number*
• Does the participant have any medical concerns which requires treatment and/or medication *
  Yes

  No
• If yes, please include details of medical condition and/or treatment needed. Example: Asthma, inhaler
• Parent/Guardian Name*
  First Name

  Last Name
• Home Address*
  Street Address*

  Address Line 2

  City*

  Province / State / Region*

  Postal Code / Zip

  Antigua and BarbudaBahamasBarbadosBelizeCanadaCosta RicaCubaDominicaDominican RepublicEl SalvadorGrenadaGuatemalaHaitiHondurasJamaicaMexicoNicaraguaPanamaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesTrinidad and TobagoUnited StatesArgentinaBoliviaBrazilChileColumbiaEcuadorGuyanaParaguayPeruSurinameUruguayVenezuelaAlbaniaAndorraArmeniaAustriaAzerbaijanBelarusBelgiumBosnia and HerzegovinaBulgariaCroatiaCyprusCzech RepublicDenmarkEstoniaFinlandFranceGeorgiaGermanyGreeceHungaryIcelandIrelandItalyLatviaLiechtensteinLithuaniaLuxembourgMacedoniaMaltaMoldovaMonacoMontenegroNetherlandsNorwayPolandPortugalRomaniaSan MarinoSerbiaSlovakiaSloveniaSpainSwedenSwitzerlandUkraineUnited KingdomVatican CityAfghanistanBahrainBangladeshBhutanBrunei DarussalamMyanmarCambodiaChinaEast TimorIndiaIndonesiaIranIraqIsraelJapanJordanKazakhstanNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLebanonMalaysiaMaldivesMongoliaNepalOmanPakistanPhilippinesQatarRussiaSaudi ArabiaSingaporeSri LankaSyriaTaiwanTajikistanThailandTurkeyTurkmenistanUnited Arab EmiratesUzbekistanVietnamYemenAustraliaFijiKiribatiMarshall IslandsMicronesiaNauruNew ZealandPalauPapua New GuineaSamoaSolomon IslandsTongaTuvaluVanuatuAlgeriaAngolaBeninBotswanaBurkina FasoBurundiCameroonCape VerdeCentral African RepublicChadComorosCongoDjiboutiEgyptEquatorial GuineaEritreaEthiopiaGabonGambiaGhanaGuineaGuinea-BissauCôte d\'IvoireKenyaLesothoLiberiaLibyaMadagascarMalawiMaliMauritaniaMauritiusMoroccoMozambiqueNamibiaNigerNigeriaRwandaSao Tome and PrincipeSenegalSeychellesSierra LeoneSomaliaSouth AfricaSudanSwazilandTanzaniaTogoTunisiaUgandaZambiaZimbabwe

  Country*
• Phone Number
   

  (###)

  -

  ###

  -

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• Cell Phone Number
   

  (###)

  -

  ###

  -

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• Work Phone Number
   

  (###)

  -

  ###

  -

  ####
• Your E-mail*
   
• Emergency Contact *
  First Name

  Last Name
• Relationship to Camper*
  >MotherFatherGrandparentAuntUncleFriendOther
• Emergency Contact Phone Number*
   

  (###)

  -

  ###

  -

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• A t-shirt is included in the price of registration. Please select the appropriate size for the camper.*
  YOUTH SMALL

  YOUTH MEDIUM

  YOUTH LARGE

  YOUTH XLARGE

  ADULT SMALL

  ADULT MEDIUM

  ADULT LARGE

  ADULT XLARGE
• I, the undersigned, submit that my son/daughter is physically fit to participate in strenuous athletic activity and, I waive and release Crossover Basketball Camp from any and all liability for any illness or injuries incurred while participating in the camp. I have no knowledge of any physical impairment that would be affected by the above-named athlete's participation in the camp. I authorize that the Directors act according to their best judgement in any emergency requiring medical attention. I hereby authorize the camp to use testimonials, photos, or video experts of the camper which may appear in the camp brochure or website or social pages. *
  Yes

  No
• Signature of Parent/Guardian*
• Payment Selection. Please allow up to 5 business days for final confirmation of registration once payment has been sent.*
  >Etransfer *Please make note of camper's nameMailing Cheque
• Any Additional Comments
• CANCELLATION POLICY: Please note our cancellation policy (All refunds are subject to a $20.00 administration fee): 30 days prior to the start of the week of camp, a complete refund (less administration fee) is available. 8 to 30 days prior to the start of the week of camp, a 50% refund (less administration fee) is available. Registration fee is non-refundable if cancelled within 7 days of the reserved week of camp or thereafter.