Basketball Camp – 3rd-5th grade — WAITING LIST

July 5–7 • 6:30-8:30pm

Rising 3rd—5th Grade

REGISTRATION IS FULL

You may fill out the following form to be put on the WAITING LIST. Please DO NOT PAY until you receive an email stating your child has a spot. Thank you.

COST: $40* per child; if spot becomes available.

* We never want cost to be the reason a child can’t come. We’re happy to work with you! If you need to coordinate a payment plan or have any questions about scholarships, please don’t hesitate to reach out via the request form and it will reach the camp lead.

PLEASE READ (applies if spot becomes available)
1. *no refunds are available for this event; to keep event fees low, we purchase supplies for many of our events well in advance.
2. **If you have any questions about scholarships, please don’t hesitate to reach out to Jesse and Megan at sports@universitycarillon.net. We never want cost to be the reason a child can’t come. We’re happy to work with you!

STEP 1: Please complete one registration form per child.

CHILD INFO

student name

First Name *

Last Name *

student info

Gender *

Birthday *

Age *

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Upcoming Grade (23-24) *

Upcoming School (23-24) *

TShirt Size *

ADDRESS

Who does child live with? *

Address *

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City *

State *

Zip *

PARENT/GUARDIAN INFO

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Parent/Guardian Name *

Cell *

Relationship *

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Parent/Guardian Name

Cell

Relationship

Home Phone

Parent Email *

Email

Confirm Email

CHILD MEDICAL INFO

Leave blank if not applicable

Allergies/Medical Needs (medical/dietary/physical needs)

FRIEND REQUEST

FRIEND REQUEST: One friend request of the SAME GRADE can be indicated below. Both friends must request each other on their form. Please understand that we cannot guarantee same-class placement. We will make every effort to place your child with the friend request submitted on their form, but there is no guarantee. Friend requests can not be made on the day of camp, due to the number of children attending the camp. For more information, please contact sports@universitycarillon.net.

Is there one particular friend your child would like to attend class with who is in the SAME GRADE? *

Yes
No

Name of friend

**Both friends must request each other on their form.**

*PHOTO/VIDEO RELEASE

For privacy and safety, we will not publish names with photographs/videos.
I authorize the use/release of photographs and/or videos that include the INDIVIDUALS NAMED ABOVE for University Carillon use, in print and electronic materials (worship videos, e-mail blasts, church website, Facebook, etc.).

Photo/Video Release: *

Given
Denied

*SUBSCRIBE — KIDS MINISTRY and/or SPORTS MINISTRY EMAIL LISTS

I would like to receive/continue to receive future KIDS MINISTRY and/or SPORTS MINISTRY emails from University Carillon. . (kids news, devotionals, UPWARD and events)
**You will still receive emails regarding this event.**

newsletter *

Yes, Kids and Sports
Yes, Kids Only
Yes, Sports Only
No, and remove from current lists

*RELEASE

Submitting this on-line form will be the equivalent of signing a paper registration form.

I have read and understand the above information. The information I have given University Carillon is accurate and true to the best of my knowledge.
My electronic signature signifies my understanding that submitting this online form will be the equivalent of signing a paper registration form.
I understand, if a spot becomes available, no refunds are available for this event; to keep event fees low, we purchase supplies for many of our events well in advance.

Release *

Yes, I agree

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Parent/Guardian Electronic Signature *

Date *

Payment via *

Pay Online (preferred)
Check

If a space becomes available, mark how you will pay.

Person making payment (if other than parent)

After submitting your form, WATCH FOR Confirmation Email.

One from our web specialist with the responses from your registration.