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Spring Camp Registration
HOOP DREAMS 2008 SPRING BREAK APPLICATION FORM
Name: _____________________________ Address: ____________________________
City: ______________________________ State: ________________ Zip: ________
Phone: _____________________________ School: _____________________________
T-Shirt: Youth Sizes: ____ M (10-12) ____ L (14-16) Adult: ___ S ___ M ___ L ___ XL
Emergency Contact: _______________________ Phone: ________________________
Please Check: ____ $175 March 31st-April 4th Hoop Dreams Spring Break Camp
Complete application and mail along with check
(Checks payable to Hoop Dreams Basketball Academy) to:
Hoop Dreams Basketball Academy
P.O. Box 23148 Lexington, KY 40523-3148
LIABILITY WAIVER
I do hereby grant permission for the above named youth to participate in any and all activities of the Hoop Dreams Basketball camp. I assume all risks and hazards incidental to such participation including transportation to and from such activities, and do hereby waive, release, absolve, indemnify and agree to hold harmless the Hoop Dreams, its respective coaches, assistants, agents, other players or parents/guardians, sponsors, supervisors, participants, volunteers and any other persons from any and all claims for damage or injury arising from any activities of this sports program. Permission is granted to the hospital and staff to provide any treatment that a physician deems necessary for the well being of the child.
_______________________________ ________________________________
Participant Parent or Legal Guardian
Date: __________________________ Date: ___________________________
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