THF 2026 March Break Madness Camp
Camper's Name
*
First Name
Last Name
Birth Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Back
Next
Family Information
Parent/Guardian's Name
*
First Name
Last Name
Contact Phone Number
*
E-mail Address
*
example@example.com
Back
Next
Emergency Contact Information
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Back
Next
Please provide any medical conditions if applicable
Select Camp shirt size
*
Youth Small
Youth Medium
Youth Large
Youth X-large
Adult Small
Adult Medium
Adult Large
Adult X-Large
I acknowledge, appreciate, and agree that: 1) The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and, 2) I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, 3) I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and, 4) I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS the Releasees, their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event ("RELEASEES"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. MEDIA RELEASE: I agree and give consent for the King Nation Basketball organization and/or partners to record, film, photograph, audiotape or videotape my child's name, image, and performance and consent to use for advertising, promotional or commercial purposes of any kind at the sole discretion of King Nation Basketball including, but not limited to, the King Nation Basketball website and all social media platforms. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
*
I Agree
EPI-PEN AUTHORIZATION and WAIVER OF LIABILITY I have informed King Nation Basketball of all my child's allergies, if any. If you have indicated an allergy that requires your child to have a Epi-Pen, medication must be left with the Camp Supervisor. It must be in the original container, and be clearly labeled with your child's full name, prescriber's name, directions for administration and expiration date. I hereby authorize King Nation Basketball Staff and agents on my behalf, to administer or attempt to administer to my child, or allow my child to self administer the lawfully prescribed EpiPen. I acknowledge that it may be necessary for the epi-pen medication to be administered to my child by an individual who is not a nurse or medical professional, and I specifically consent to such practice. I hereby waive any claim for myself, my heirs, executors, assigns, or personal representative that I might have against King Nation Basketball, its employees, officials, or agents from and against any and all claims, damages or causes of action arising out of or in any way connected to the self-administration, administration, failure to administer, or attempt to administer epi-pen medication to my child. I further agree to protect, indemnify, defend and hold harmless King Nation Basketball, its employees, officials or agents arising out of or in any way connected to the self administration, administration, failure to administer or attempt to administer medication to my child. I authorize and recommend self-medication by my child for the epi-pen medication. In the event my child is unable to self-administer or if I have recommended that my child not self- administer, Staff have my permission to administer the epi pen for my child in the event of an allergic reaction.
*
I Agree
Please select an option
*
prev
next
( X )
Half Day Camp | Monday - Friday | 9:00 AM - 12:00 PM
$
250.00
Full Day Camp | Monday - Friday | 9:00 AM - 4:00 PM
$
350.00
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit Form
Submit Form
Should be Empty: