WNY Camper Registration 2

Parent's Information
First Name
Last Name
Street Address
City
State /Province / Region
Email*
Phone*
Camper's Information
Camper's Name
Session
Gender
Grade
Grade
Age
T-Shirt Size
T-Shirt Size
Medical Information*
List all of the child’s conditions, injuries, medications, allergies and special diets.
Emergency Contact Information
Fist Name
Last Name
Emergency Contact Phone
Type of Payment
* If you are paying with a credit card, you will be redirected once you submit your registration.
- Cash
- Check
- 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
*
- I Accept Waiver

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Parent's Information