Information



Starts:
Days of the Week:
Time:
Grades:
Size:
Location:
Cost:

Sign-up Form

Child's Name:


First	Middle Initial	Last

Sex:

Grade:

Height:

feet, inches

Weight:

pounds

Age:

Level(s) of play:

Middle School Frosh J.V. Varsity

If varsity:

First Team Second Team Third Team

Parent's Name:


First	Middle Initial	Last

Address:

(Street Address)
(Apt, Suite)

City:

State: Zip Code:

Home Phone:

( ) -

Emergency Phone:

( ) - Ext.

E-mail:

e-mail is required for confirmation of the deposit and for further camp information
Notify me of upcoming events

Confirm E-mail:

Insurance Carrier:

Policy Number:

Type the following verification code into the box below:

I give Madison Hoop Dreams Basketball Camp permission to publish in print, electronic, or video format the likeness or image of my child. I release all claims against Madison Hoop Dreams with respect to copyright ownership and publication including any claim for compensation related to the use of the materials. ***

*** Images of minors under the age of 18 are not identified under any circumstances. No names or information relating to the minor's identity are published. If you have any questions, please contact Coach Bill Barker at coachbarker@madisonhoopdreams.com.