WOU Men's Basketball Elite Camp | Accounting & Business Services

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Date

Men's Basketball Elite Camp

Athlete's Name*

First Last

Age*

Grade (Fall '24)*

T-Shirt Size

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Parent or Guardian Name*

First Last

Parent or Guardian Address*

Street Address Address Line 2 City State ZIP Code

Parent or Guardian Phone*

Parent or Guardian Email*

School

School Coach

Primary Position

Secondary Position

Emergency Contact Name*

Emergency Contact Relationship

Emergency Contact Phone*

Product Name

Total

$0.00

I hereby register my child for the WOU Men's Basketball Camp(s) and authorize the staff to direct my child in participation of the camp activities.
I know of no mental or physical problems that may affect my child’s ability to safely participate in this camp. I acknowledge that I am responsible for any and all medical or other charges incurred in connection with my child’s attendance at the WOU Basketball Camp(s).
In consideration for my child’s participation in the WOU Men's Basketball Camp(s), I hereby release and hold harmless the WOU Men's Basketball team, coaches, Western Oregon University and its employees, agents and assignees from any and all liability that may arise out of my child’s participation in the camp including transportation to and from, or in connection with said school in any vehicle operated on behalf of the WOU Men's Basketball Camp staff and Western Oregon University.
The WOU Men's Basketball Team or employees thereof are authorized to seek medical treatment as necessary in the event of injury, accident or illness to my child.
By attending this event, you agree to be photographed and/or filmed and give permission to use your likeness in promotional and/or marketing materials.
Submission of this form represents your acceptance of these terms and conditions.

I have read the WOU Camp Activity Waiver*

Insurance Company*

Insurance Group Number

Insurance Policy Number*

Total

$0.00

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