Camp Choice*Cheer (Girls only ages 6-12)Soccer (Boys/Girls ages 6-12)Flag Football (Boys only ages 9-12)Basketball (Boys/Girls ages 8-12)Shirt Size*Youth SYouth MYouth LAdult SAdult MAdult LAdult XLChild Name* First Last Age*Bring Your Own Ball?*YesNoGender*MaleFemaleGrade*Birth Date* Date Format: MM slash DD slash YYYY Parent/Guardian Name* First Last Relationship to Child*Email* Authorized Adult Pickup (other than Parent/Guardian)* First Last Address* Street Address Address Line 2 City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Emergency Name* First Last Emergency Phone*Allergies / Health Issues: (If none, list NA)*Special Requests: (If none, list NA)*Consent* I agree to the: Medical and Liability Release(PLEASE READ CAREFULLY) We realize that no activity is without the possibility of unforeseen hazards which could result in injury to an individual. As a parent or guardian, you are to be aware of your responsibility to instruct your child of the importance of conduct which will insure safety and enjoyable time while participating in this activity. By signing this form, you, as a parent/guardian or other responsible party, agree to assume the risks and hazards which are inherent in this kind of activity. You also agree to absolve and hold harmless the sponsoring organizations and their representatives for damage, loss or injuries to the child for whom you sign. I further give my permission for the use of any photo or likeness of my child to be used by the sponsoring organizations for their use in promotional materials. I give my child permission to participate in this activity, and give my permission to the leaders of this function to authorize any treatment deemed necessary by a licensed physician due to accident or illness during this activity.Signature*CAPTCHA This iframe contains the logic required to handle Ajax powered Gravity Forms.