Ball Above All - Summer Camp!

PARTICIPANT INFO

Name

AGE

PARENT/GUARDIAN INFO

Name

Phone #

Area CodePhone Number

E-mail

Additional Participants

Please share list of names & ages of additional participants. Each member requires a separate entry.

Program Details

- Standard Rate: $160 after 6/1 with sibling discount of $130 per child

65 dollar daily drop in

- Summer Camp Dates: June 9th - July 2nd

- Meets Tuesday, Wednesday, Thursday

- Times: 10:00 a.m. to 1:00 pm

- 4-week program

Schedule

- Morning Workout

- Midday Competition

- Afternoon dialog with attendees

Emergency Contact & Health Insurance Information

Emergency Contact's Name

First NameLast Name

Relationship

Phone Number

Area CodePhone Number

Parental Permission For Emergency Treatment for those <18yrs

In the event of illness or accident, I give my permission for emergency treatment by qualified medical personnel for my child, and I authorize Stronger Together Now & the partnered facility to ensure any and all necessary emergency medical care are provided for my child.

Name of Current Physician / Emergency Medical Care Facility

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Area CodePhone Number

PROGRAM PACKAGES

Early Bird $120.00

Sign up by June 1st

Standard Rate$160.00

Rate after May 25th

Sibling Rate$130.00

Rate for siblings, once after another child has signed-up

Weekly Drop-In Rate$65.00

Weekly rate for drop-ins only

Daily drop in rate$10.00

Donation (whatever you can donate is appreciated)Free

Please donate whatever amount you can. This helps our non profit and allows us to support the community this way. Anything is appreciated 🙏🏽

Total $0.00

Release of Liability

Although the safety of all sport activities is the primary concern, indoor sport activities at Stronger Together Now and its affiliated facilities may cause injuries and/or death. I expressly assume the risk of injury, death, and/or illness arising from any cause, and agree to waive the right to pursue any claim against the Stronger Together Now and the persons in charge, as well as the affiliated facilities that hold the tournaments.

I have read and agree to the above conditions

Individual signature

Parent Signature (if applicable):

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

PROGRAM PACKAGES*

Release of Liability

Payment Methods

PROGRAM PACKAGES