Basketball Camp Registration
Camp Registration PDF Download
Camper's Name
(Required)
First
Last
Age
(Required)
Date of Birth
(Required)
MM slash DD slash YYYY
Sex
(Required)
Male
Female
What school does the camper attend?
(Required)
What grade is the camper in?
(Required)
Street Address (or PO Box)
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Has Your Child Attended Crossfire Camp Before?
YES
No
Camper's T-Shirt Size (select size)
(Required)
Youth Medium
Adult Small
Adult Medium
Adult Large
Adult XL
Parent / Guardian Name
(Required)
First
Last
Phone Number
(Required)
Email
(Required)
Relationship To Camper
(Required)
Second Parent / Guardian Name
First
Last
Phone Number
Email
Relationship To Camper
How Did You Hear About Crossfire?
Website
Social Media
TV or Radio
Printed Camp Flyer
Billboard
Newspaper Media
Road Signs & Banners
Other
Insurance Information (Carrier)
(Required)
Emergency Contact (if differs from above)
Relationship To Camper
Emergency Contact Phone
Medical Administration Consent (OVERNIGHT CAMPERS ONLY)
You can give Acetaminophen (Tylenol) to my child
You can give Ibuprofen (Advil) to my child
You can give Antacid (Tums) to my child
No medications please
Untitled
Allergies For Which Staff Needs To Be Aware
Consent Form
(Required)
I Understand & Agree
It is understood that Crossfire Ministries, Intl. reserves the right to require additional information and documentation related to this application and filed with Crossfire Ministries, Intl. before camp participation is allowed.As the parent or guardian of the camper, you represent to Crossfire Ministries that said child is free from any physical or mental impairment or condition that would prevent him/her from participating in camp activities. I, as the parent, further represent to Crossfire Ministries, Intl. that said child has no medical condition that requires medication or medical attention OR child does have a medical condition that requires medication or medical attention, as described in the following space.I further assume all responsibility for any possible health problems or accidents which might occur while my child is in camp and will not hold responsible the following parties/organizations: Crossfire Ministries, Asheville School, Asheville Christian Academy, First Baptist Church of Hendersonville, Mars Hill University, North Buncombe Middle School and North Buncombe HIgh School.
If camper has a Medical Condition which requires prescription medications, please list the name of the medicines/amount/time of administration:
We will try to honor roommate/suitemate requests received. This is a first come serve basis. Very Important: In order to try and secure your choice, please make sure the requested roommate has also requested your child. This is the parent and camper’s responsibility. Roommate/Suitemate preference (one name only)
Half-Day Basketball Camp at First Baptist Church Hendersonville
Quantity
Price:
$100.00
Quantity
DETAILS Start: June 26 @ 1:00 pm End: June 30 @ 4:30 pm Boys & Girls Ages 6-12
Half-Day Basketball Camp at Asheville Christian Academy
Quantity
Price:
$100.00
Quantity
DETAILS Start: July 10 @ 1:00 pm End: July 14 @ 4:30 pm Boys & Girls Ages 6-14
Full-Day Basketball Camp
Quantity
Price:
$250.00
Quantity
DETAILS Start: July 24 @ 8:30 am End: July 27 @ 5:00 pm Boys & Girls Ages 9-18
Overnight Basketball Camp
Quantity
Price:
$375.00
Quantity
DETAILS Start: July 23 @ 3:00 pm End: July 27 @ 5:00 pm Ages 9-18
Total
Payment Method
*
Credit Card
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number
Expiration Date
Security Code
Cardholder Name
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