KSL Kid’s Camp January 2019

Welcome to the registration form for the KSL Kids January 2019 Basketball Camp.
Please enter all the correct information below, the end of the registration displays the bank details to transfer your payment. Please enter the child's name in your description. Please complete payment immediately after you have completed this registration form.

Guardian's Name*

Given Name Surname

Address

Street Address City State Post Code

Guardian Primary Contact Number*

Guardian Secondary Contact Number

Guardian Email Address*

Number of Children*

First Child's Name*

Given Name Surname

First Child's Date of Birth*

First Child's T-Shirt Size*

XS
S
M
L

First Child's Favourite NBA Team*

First Child's Medical Conditions (If Any)

Second Child's Name*

Given Name Surname

Second Child's Date of Birth*

Second Child's T-Shirt Size*

XS
S
M
L

Second Child's Favourite NBA Team*

Second Child's Medical Conditions (If Any)

Third Child's Name*

Given Name Surname

Third Child's Date of Birth*

Third Child's T-Shirt Size*

XS
S
M
L

Third Child's Favourite NBA Team*

Third Child's Medical Conditions (If Any)

Price $110.00 per child
Acc. Name - KSL January 2019
BSB – 736-302
Acc.# - 656-592
(Please put child’s name in the description)

I wish to enrol my child/children in the above camp. I understand the KSL staff and volunteers will take all reasonable care of my child/children and I will not hold them responsible for any damage and/or loss of property and/or accident.
In case of any accident or untoward incident, I will give my consent for any necessary medical treatment and agree to meet all expenses incurred.
I realize that I am responsible for informing THE KSL staff of any medical conditions that may effect my child’s/childrens participation in this program.

I accept the terms and conditions*

Yes
No