Delaware Adidas Phenom Camp
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Contact Information
First Name:
Last Name:
Address:
City:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
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Texas
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Washington
West Virginia
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Zip Code:
Phone:
Parent Cell:
Email:
General Information
Grade:
4th
5th
6th
7th
8th
9th
School Team:
GPA:
AAU/Travel Team:
Position:
Point Guard
Shooting Guard
Small Forward
Power Forward
Center
Height:
Weight:
Uniform Size:
S
M
L
XL
XXL
Hobbies:
Favorite Athlete:
Nickname:
Insurance Information
Carrier:
Policy #:
Group #:
Medical Information
Allergies:
Medications:
Emergency Contact
Name:
Phone:
How did you hear about the camp?
DelawareGirlsBasketball.com
Flyer
Coach
School
AAU/Travel Team
Boys and Girls club/YMCA
Friend
Urban Youth Inc.
Other
I submit that my daughter is physically fit and able to participate in strenuous activity and hereby waive Delaware Adidas Junior Phenom Camp of all responsibility for illness or injury sustained. I hereby authorize camp directors to act on my behalf in their best judgment in any emergency medical situation. I understand I am solely responsible for payment of any such medical expenses and must provide Delaware Adidas Junior Phenom Camp with proof of medical and accident insurance. I understand that my payment and deposit are non-refundable and non-transferable under any circumstances, including injuries sustained, conflict of schedule and illness and that Phenom products can not be given in lieu of any refunds. I also understand that any camper who does not abide by camp facility rules or regulations is subject to dismissal without refund or recourse.