Summer 2023 Youth Basketball Camp Registration Form

Valley Youth Sports Association Summer 2023 Basketball Camp will be on Monday July 31 - Thursday August 3rd at Smith Academy (34 School St, Hatfield, MA 01038). There will be 2 sessions, Group A (7-10 year-olds) in the morning and Group B (11-14 year-olds) in the afternoon. Check-in for Group A is at 9AM and the check-in for Group B at 1pm on Monday July 31st. Each participant will need to bring a water bottle.

Camper's Full Name: *

Address: *

Birthday * +

Age *

Gender *

What group are you registering for? Reminder that check-in is at 9:00am for Group A and at 1:00pm for Group B is on Monday July 31st. *

Group A (7-10 year-olds) 9:30am-11am

Group B (11-14 year-olds) 1:30pm-3pm)

Contact information

Parent name *

Email *

Phone number *

Preferred method of contact *

Phone

Text message

Emergency contacts

Emergency contact name *

Emergency contact phone number *

Consent & Liability Waiver

As the legal guardian of the participant being registered on this form, per lawful consideration for being permitted to participate in the Summer Camp hosted by Valley Youth Sports Association (VYSA), I acknowledge that this release is intended to discharge in advance VYSA and their agents, sponsors, and volunteers from and against any and all liability, including for negligent actions, arising out of misconduct. I FURTHER UNDERSTAND THAT SPORTS INVOLVE PHYSICAL CONTACT BETWEEN PLAYERS, THAT SERIOUS ACCIDENTS OCCASSIONALLY OCCUR DURING SUCH SPORTING ACTIVITIES, AND THAT PARTICIPANTS IN SUCH SPORTING ACTIVITIES OCCASSIONALLY SUSTAIN SERIOUS PERSONAL INJURIES. AS A CONSEQUENCE THEREOF, KNOWING THE RISKS OF PARTICIPATION, NEVERTHELESS, I HEREBY AGREE TO ASSUME THOSE RISKS AND TO RELEASE AND HOLD HARMLESS VYSA and its volunteers. I further attest that the participant above is physically fit and have no known medical conditions which prohibit participation in this sport and that they agree to follow all laws, rules and guidelines regulating the conduct of the summer basketball camp. BY ENTERING MY FULL NAME BELOW, I AGREE THAT I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF AND VYSA, AND THEIR AGENTS, SPONSORS, AND VOLUNTEERS AND I HAVE SIGNED IT OF MY OWN FREE WILL.

Do you give VYSA media release permission for the participant's pictures from this camp? *

Yes

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