SUMMER PROGRAM – 2024 REGISTRATION FORM

SUMMER PROGRAM – 2024 REGISTRATION FORM

As we gear up for an exciting summer of basketball camps, we want to inform you about the upcoming selection process for participants. Camp participants are carefully chosen based on excellence in the following four categories: Academics, Athletics, Attitude, and Attendance. In addition, to be eligible for consideration, students are required to register and participate in Crossover Mission’s Summer Program.

Non-summer program participants are not eligible to participate in basketball camps.

We understand the enthusiasm surrounding the basketball camps, and we appreciate your commitment to Crossover Mission. We look forward to a fantastic summer!

SUMMER PROGRAM - REGISTRATION FORM

Step 1 of 3

Student Information

Student Name(Required)

First Last

Gender(Required)

Male

Female

Prefer not to answer

Date of Birth(Required)

Age(Required)

Grade in Fall 2024(Required)

Parent/Guardian Information

Phone Number(Required)

Family Email(Required)

Enter Email Confirm Email

Home Address(Required)

Street Address City State ZIP Code

Parent/Guardian 1 Name(Required)

Parent/Guardian

First Last

Cell Phone(Required)

Work Phone

Does the student have more than one parent or guardian?(Required)

Yes

No

Parent/Guardian 2 Name(Required)

First Last

Cell Phone(Required)

Work Phone

Emergency Contact Name (other than parent/guardian)(Required)

First Last

Please list the names of anyone who is authorized to pick your child up from camp:(Required)

Medical issues, daily medications, or special needs:

SUMMER PROGRAM - REGISTRATION FORM

Student Information

Parent/Guardian Information

Consent