Rising Stars Basketball

RISING STARS REGISTRATION FORM AND EASY TRANSITION TO SHOPPING CART FOR PAYMENT AND CONFIRMED ENROLLMENT

After completing the registration form below and selecting the correct event please click "submit form" at the bottom of this page to be automatically transfered to our shopping cart. REGISTRATION IS NOT COMPLETE until all information is filled out AND full deposit/tuition has been received (please select camp location and days your child is attending) and continue processing the order. Your child will then be fully registered and will receive an email confirmation directly upon payment. Thank you!

You must compete this form, and pay for the camp in our shopping cart to be registered for a Rising Stars Basketball Camp.

Camper Name*
Child's First Name:  

Child's Last Name:

Please put your child's preferred name as we use this information for their nametag for the week.
Please do not use parent's or other first names
Age on Event Start Date*
Best Cell Phone Number*
(XXX) XXX-XXXX
If for some reason a player's parent or guardian is not present, we must be able to contact you in case of injury. We require a cell phone # or pager # where you may be reached at all times your child is unaccompanied. This number will be kept confidential and only used in an emergency.
Email Address*

Address*

Address Line 2
City*

Zip Code*

School Camper Attends*

   
Insurance Company*
Camper Gender*
Select an Event*
  

Waiver:

I hereby authorize the staff of Rising Stars Basketball Clinics, Inc. ("Rising Stars") to act for me according to their best judgment in any situation requiring medical attention for the person ("my child") participating in Rising Stars' activities ("camp") pursuant to this registration form. I hereby waive and release Rising Stars, its owners, employees, and agents from all liability related to or arising out of the participation of my child in camp, and I agree to accept responsibility for all medical expenses incurred related to or arising out of my child's participation. This waiver and release applies to all activities related to or arising out of my child's participation in camp, including, but not limited to, injury or illness occurring or contracted during camp. I know of no physical or mental condition that limits my child's ability to safely participate in camp. By initialing the box below and an signing this registration form, I confirm that I have read and understood this waiver and release.

By initialing in the box below I confirm that I have read and understand the above waiver

*

 
When you click on the "Submit Form" button you will be re-directed to the Shopping Cart where you pay for your child's registration - Thank You!!

Please do not hit the submit button more than once