REGIONAL ADIDAS JR. PHENOM CAMP REGISTRATION

All Fields Must Be Completed
First Name:   Last Name: 

Address:

City:  State: Zip Code:

Phone Number: E-mail:

School: GPA:

Team:  Birthdate:

Position: Ht: Wt:

Gender:  Male  Female

Class of: 2019 2018 2017 2016

Uniform Size: Shorts Jersey

THE SIZE OF THE UNIFORM ORDERED WILL BE THE ONLY UNIFORM SIZE ISSUED
AT REGISTRATION NO EXCHANGES
INSURANCE INFORMATION
Carrier:

Policy#

Group#


I, the undersigned, submit that my child is physically fit and able to participate in strenuous activity and hereby waive Adidas Jr.  Phenom Camp of all responsibility for illness or injury sustained.  I hereby authorize the camp director 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 expense and must provide Adidas Jr. Phenom Camp with proof of medical and accident insurance.  I also understand that my payment is non- refundable under any circumstances.  I understand that the camper who does not abide by camp facility rules and regulations is subject to dismissal without refund or recourse.

Camp Fees:  $195.00 (includes uniform)
Click the "SUBMIT" button below to go to the Payment Page of the Online Registration