Boy's Form

** All fields are required!
All applications must be mailed with deposit and completed registration.
Staff reserves right to refuse camper's registration if form is missing data.

Camper's Name (Girls):

Approval Code:

First:

Last:

Address:

City:

State:

Zip:

Phone:

Cell:

Email:

All correspondence will be through email please provide email address

School Team:

GPA:

Travel Team:

Birthdate:

Position:

Ht: Wt:

Gender:

Female

Class of:

2013 (rising 10th) 2014 (rising 9th)

Insurance Information:

Carrier:

Policy#:

Group#:

I, the undersigned, submit that my daughter is physically fit and able to participate in strenuous activity and hereby waive Phenom Basketball Inc. 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 Phenom Basketball Inc. with proof of medical and accident insurance. I understand that my payment and deposit is non-refundable, non-transferable under any circumstances, including injuries sustained, conflict of schedules, or illness. I understand that Phenom products can not be given in lieu of any refunds. I also understand that any camper or parent who does not abide by camp facility rules or regulations is subject to dismissal without refund or recourse.

Parent/Guardian Signature:Date:

Camp Fees (select one): NO REFUNDS

-- $475 (You take care of your own housing)

-- $550 (Housing in the dormatory--2 night's stay; Fri/Sat night)

-- $150 non-refundable deposit secures your spot - Required with application

Items You Must Provide in the registration packet:

º Proof of grade (report card, letter from school or progress report)

º 3 x 5 photo (can be mailed or emailed) - We prefer pictures to be emailed

º Completed Biography

º Registration form

º Registration fees or deposit

Send Registration to:
Phenom Camp Basketball Inc., 26563 Rhone Ct., Moreno Valley, CA, 92555

Phenom 150 Camper's Biography

Player's Name:
Address:
City, St, Zip:
Contact Info:	Phone: email:
School Team:
Travel Team:
Allergies:
Medications:
Emergency Contact:	(name & telephone)
Position:
Height:
Weight:
Class:	2013 (rising 10th) 2014 (rising 9th)
Uniform Size:	adult size: Uniform comes in a set in adult sizes only
Hobbies:
Fav Athelete:
Nickname:
	Registration Checklist:
	Registration Form
	Biography Form
	Proof of Grade
	Registration Deposit/Fees
	Photo for Camp Program

* These items must be submitted in full for registration to be accepted. Please check items before submitting.*