Canadian Academy Student Registration

Parent's Information
First Name*
Last Name*
Email*
Phone*
Athlete's Information
Athlete's Name*
Grade
Gender
Age
T-Shirt Size
Medical Information*
List all of the child’s conditions, injuries, medications, allergies and special diets.
Emergency Contact Information
First Last
Emergency Contact Phone
Payment
* If you are paying with a credit card, you will be redirected once you submit your registration.
*
- Credit Card/Paypal
Waiver
I hereby hold hoop Vizion basketball camp, it's staff free from liability should any injury or illness befalls me while I am in attendance at hoop Vizion basketball camp. I also authorize the coaches and staff of hoop Vizion to secure medical treatment for me should I not be able to request such treatment for myself. I have no knowledge of any existing physical impairment that would affect my participation in this program. Lastly, I authorize hoop Vizion to use any photography taken during the program for use in publicizing and advertising future hoop Vizion events.
*
- I Accept Waiver

Parent's Information