Basketball Skills Camps

Lyons Community Camp:

Location: 9 Manhattan Street Lyons, NY 14489
Open to all athletes
July 10th & 11th
9am-12pm
Grades 3rd-11th

Liability Statement: Students are responsible for their actions at all times. PrimeTime585 is not liable for loss or theft of personal property, injuries, or any other claims.

Student Information

First Name

Last Name

Phone

(###)

###

####

Email

Gender

School

Class of

Home Address

Height

Twitter

@

Instagram

Medications

Allergies

Parent/Guardian Information

First Name

Last Name

Phone

(###)

###

####

Email

Student Name

I give the following student permission to attend PrimeTime585 Coach Iglesia Free Basketball Camp, & I give permission for medical attention for my child in case of an emergency:

Media Consent: By signing this form, this student and parent/guardian gives consent to the release of information relative to the student’s participation in the PrimeTime585 Coach Iglesia Free Basketball Camp related to photographs, videos, and social media.

Check this box to sign this form