EMERALD GEMS

2018 4th Annual U.S.V.I. Youth Basketball Camps

REGISTRATION FORM

CAMPS ARE FULL

Ages 8-13: Tuesday, July 31 to Wednesday, August 1

Ages 14-17: Thursday, August 2 to Friday, August 3

9-3 P.M. (All Days)

Ivanna Eudora Kean High School

Registration Form deadline is Monday, June 11, 2018. Apparel and basketball shoes are not guaranteed.

If your child secures a camp spot, you will receive a confirmation email

within a week of your submission.

For Ages 8-13: First come, first served for up to 50 camp spots.

For Ages 14-17: Up to 50 campers will be selected.

Local coaches may assist with the selection process. Must complete a Registration Form to be considered.

Child's Information

First Name: *

Last Name: *

Gender *

Birthdate (xx/xx/xxxx): *

Height: *

Address: *

U.S.V.I *

Zip Code: *

Jersey Size: *

Shorts Size: *

Basketball Shoes (Indicate Youth or Adult): *

Shoe Size: *

Parent/Legal Guardian Information

First & Last Name: *

Email Address: *

Cell Number: *

Address (if different than above):

Home Number:

Work Number:

Emergency Contact Name: *

Phone Number: *

Relationship to Camper: *

If a field is not applicable, please enter N/A.

Health Care Company: *

Group Number: *

ID/Policy Number: *

Primary Care Physician: *

Phone Number: *

Health concerns, including allergies: *

Terms & Conditions *

By Checking This Box, I'm agreeing to the Terms & Conditions.