Registration Information | Seaside Basketball Tournaments

Pacific Basketball League Summer Hoop Camp

Sunset Recreation Center
Monday-Thursday, June 20-23 2022
A great opportunity to learn fundamentals from current and alumni athletes and be part of a championship program in Seaside!

Session 1: 9:00am-11:00am for incoming 1st through 4th graders
Session 2: 12:00pm-2:30pm for incoming 5th graders through 8th graders

Cost: $90 per child.
$100 registering after June 13th
Checks payable to Pacific Basketball League or PBL
PO Box 1015 Seaside, OR 97138-1015

Questions or additional information:
503-717-4308
Email kkjanuik@gmail.com

PDF Form

Name

Grade in School (22-23)

Phone

Email Address

Mailing Address

City

State

Zip

Gender

Boy

Girl

T-shirt Size (Youth or Adult available, please specify)

Please Indicate Session

Sesssion 1 (9:00am-11:00am)

Session 2 (12:00pm-2:30pm)

Insurance

I have insurance with

Policy or ID number

Group Number

Consent for Medical Care & Treatment

Please notify the undersigned parent or guardian as noted below in case of an accident, serious illness or other emergency. In the event you are unable to notify me, I hereby authorize medical personnel to secure whatever medical or surgical care is deemed reasonable necessary. Also, the undersigned further agrees to guarantee payment therefore.

Name of family physician

Physician Phone

Parent or Guardian Signature

Date

Allergies or special medical conditions

Nearest relative or friend in case you cannot be reached

Phone Number

Waiver and Release of Liability

In consideration of being allowed to participate in the Pacific Basketball League summer camps, the undersigned acknowledges and fully understands that each participant will be engaging in activities that involve risk of serious injury, including permanent disability and death. Further, there may be other risks not known to us or not reasonably foreseeable at this time. The undersigned agrees to assume all the financial obligations following such injury, disability, or death. The undersigned releases and agrees not to sue Pacific Basketball League, their coaches and directors from all liability. I/we have read the above waiver and release, understand that I/we give up substantial rights by signing it and sign in voluntarily.