Official Registration Form

July 19, 20 & 21
Session 1: 8:00am-11:30am (Completed 3rd - 5th grade)
Session 2: 12:30pm - 4pm (Completed 6th-8th grade)
Tellepsen Family Downtown YMCA

Sign up now!
 
This registration form is for one child at a time, if you would like to register multiple kids, please complete the form multiple times.

 
Hello! What's your child's first name only? *

If you are registering multiple children, you will need to complete this form multiple times.
 
What's {{answer_Tpts}}'s last name? *

 
Which camp are you signing up for? *


 
{{answer_Tpts}} is: *


 
How old is {{answer_Tpts}}? *

 
What grade did {{answer_Tpts}} just complete? *

Note that camp #2 has two sessions:
Session 1:  8:00am-12:30pm (Completed 3rd - 5th grade)
Session 2:  
11:30am - 4pm (Completed 6th-8th grade)

3-5th grade camps are currently full for the Northbrook camp. Please register for the downtown camp July 19th, 20th, and 21st.

 
What's {{answer_Tpts}}'s Shirt Size? *

T-Shirts will be handed out at the end of the first day of camp. It would be really awesome if your child could wear their shirts on days 2 & 3.

 
Could we have the Parent or Guardian's name?

 
What's {{answer_51094697}}'s phone number? *

 
Could we have your address, please? *

 
Who is a good emergency contact? Please list their name and number. *

 
Is there anyone specific {{answer_Tpts}} would like to have on their team?

 
Does {{answer_Tpts}} have any medical conditions, allergies, or medications that we should be aware of?

 
If {{answer_51094697}} has a different phone number than {{answer_51096549}} please list it below.

 
Media Release
I hereby grant permission for my child's photographs to be included in the newsletters, brochures and website related to the Hoops for Kids camp. *

     
 
Liability Release and Medical Authorization *

I agree to abide by all the policies and procedures of said Hoops For Kids. I assume all the risk and responsibility due to bodily injury and/or damage of equipment as I involve myself in activities within Hoops for Kids. I hereby release Hoops for Kids and all persons acting on its behalf from any and all claims, actions, course of action and whatsoever kind of nature arsing from or by reason of any injuries and the consequences thereof incurred at the Hoops for Kids Basketball Camp. Furthermore, in the event of any injury, I hereby authorize the Hoops for Kids staff to administer necessary first aid.
     
 
The cost per student is: {{var_price}} *

This is for one child each.
 
Please enter your Credit or Debit Card number: *

 
The CVC number: *

(3 or 4 digit security number on the back of your card)
 
The name on your card: *

 
Your card's expiry month: *


 
Your card's expiry year: *


Tell {{answer_Tpts}} to get excited. You're coming to Hoops!
Your registration has been recieved successfully!
Thank you!

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