Student Athlete Summer Registration

We welcome you to the Crossover Mission Student Athlete Registration Application.

I would like to register my student for:*

Summer Camp June 1-5, $75.00
Summer Camp June 8-12, $75.00
Summer Camp June 15-19, $75.00
Summer Camp June 22-26, $75.00
Summer Camp June 29-July 2, $75.00

Are you a new or returning student?*

New Student
Returning Student

Date*

Student Name*

First Last

Student Nickname

Birth Date*

Age*

Address*

Street Address City ZIP Code

Height*

Weight*

Gender*

Male
Female

Student Cell

Student Email Address

School Name*

School Dismissal Time*

Grade*

Student ID*

Student - T Shirt size*

Uniform size

Student - Shorts size*

Uniform size

Student Desired Level of Basketball Training*

Competitive Basketball
Recreational Basketball

Previous Basketball Experience (check all that apply)*

No previous organized basketball experience
Recreation basketball participation
School basketball team participation
Travel basketball team participation

Parent/Guardian Information

This field is hidden when viewing the form

Date

Parent/Guardian*

First Last

Parent/Guardian Nickname

Relationship to the Student*

Parent Cell Phone*

Please use your preferred phone number where you can be reached most often

Parent Email*

Email will be the primary form of communication for schedules and events from Crossover Mission. If your email changes, please notify us immediately.

Parent/Guardian Address*

Street Address City ZIP Code

Occupation*

Employer*

How did you hear about Crossover?*

Tell us more about how you got interested in Crossover

Does the student have a second parent or guardian?*

Yes
No

Parent/Guardian #2

Parent/Guardian #2 (if applicable)

First Last

Parent/Guardian Nickname

Relationship to the Student

Parent Cell Phone

Please use your preferred phone number where you can be reached most often

Parent Email

Email will be the primary form of communication for schedules and events from Crossover Mission. If your email changes, please notify us immediately.

Parent/Guardian Address (if different from above)

Street Address City ZIP Code

Occupation

Employer