Online Registration Form

: REQUIRED INFORMATION

Contact Information

Athlete's Full Name:
Address:
City:
State:
Zip Code:
Parent(s) Name:
Home Phone:
Parent Cell:
Email:
General Information
Grade:
School Team:
GPA:
Travel Town Team:
Position:
Height:
Weight:
Uniform Size:
Hobbies:
Favorite Athlete:
Nickname:
Insurance Information
Carrier:
Policy #:
Group #:
Medical Information
Allergies:
Medications:
Emergency Contact
Name:
Phone:
How did you receive an Invitation to NH Phenom Basketball?

I submit that my son/daughter is physically fit and able to participate in strenuous activity and hereby waive New Hampshire Adidas Junior Phenom Camp of all responsibility for illness or injury sustained. I hereby authorize camp directors 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 expenses and must provide New Hampshire Adidas Junior Phenom Camp with proof of medical and accident insurance. I understand that my payment and deposit are non-refundable under any circumstances, including injuries sustained, conflict of schedule and illness, but are transferrable and that Phenom products can not be given in lieu of any refunds. I also understand that any camper who does not abide by camp facility rules or regulations is subject to dismissal without refund or recourse.

New Hampshire Adidas Phenom Camp