SUMMER CAMP REGISTRATION — WELCOME TO LOS ANGELES ELITE

SUMMER basketball CAMP registration form

LOCATION:
Champions Sports Facility
205 W Torrance Blvd Carson ca 90745

Any questions, please do not hesitate to reach out to us at:
Zach Stiffel, Camp Director
Zstiffel@losangeleselite.com | 310.529.7750
#PlayersFirst

FULL WEEK OPTIONS

FOR THE PLAYERS WHO SIGN UP FOR FULL WEEK CAMP

CAMP DATE OPTIONS

FOR THE PLAYERS WHO SIGN UP FOR DAY CAMP

player's Name

First Name

Last Name

grade/class (hs graduation)

Date of birth

YYYY

HEIGHT

school

player's Phone number

(###)

###

####

player's Email

instagram handle

parent's Name

First Name

Last Name

parent's Phone number

(###)

###

####

parent's Email

home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Universal permission and medical release statement in consideration of my child or ward participating in the LA Elite basketball programs and with full knowledge of the risks of injury, such as sprains, fractures, paralysis, or even death, I, for myself, my spouse, my child or ward, and my and their heirs, administrators, successors and assigns, hereby authorize the TBC coaches, assistant coaches, officers, directors, and volunteers, along with tournament sponsors, directors, officials and volunteers, ,to administer emergency medical treatment to my child or ward for any injury or other medical emergency while at practice, at a game, at a tournament or while traveling to or from any of these events.

This permission and consent extend the right to those enumerated above to arrange for medical treatment by a licensed or certified physician and/or other medical personnel, and for them to apply such emergency techniques which, in their judgment, they deem appropriate to treat an injury or illness sustained by my child or ward. Release of claims on behalf of myself, my spouse, my above-named child or ward, and my and their heirs, administrators, successors, and assigns, I hereby waive, release, and discharge TBC and its insurers, predecessors, successors, assigns, officers, directors, employees, attorneys, agents, coaches, volunteers, members and participants from any and all claims, obligations, and liabilities that may presently exist or that may exist in the future arising from any injuries to the person or property of my above-named child or ward that resulted from or related to, or that in the future may result from or relate to, his participation in any TBC activity including, but not limited to, his participation in TBC sponsored games, clinics, practices, his travel in connection with such activities, and the administration of emergency medical care as authorized in this document. I further verify that my child or

AUTHOrized parent/guardian name