Youth Football Camp Registration

Player Name (required)

Date of birth (required)

Gender (required)

Male

Female

Grade in 2025-26 (required)

4

5

6

Address (required)

Parent/Guardian (required)

Relationship to Camper (required)

Phone (required)

Emergency Contact (required)

Phone (required)

Shirt Size (required)

Medical Conditions (required)

I understand that this is a community youth organization and my childs photo may be published as a participant in the activities he/she has registered for (required)

yes

PARENT/GUARDIAN AGREEMENT AND AUTHORIZATION FOR PARTICIPATION By my signature below, I confirm that the above is true to the best of my knowledge. Furthermore, I agree to encourage my child to show good sportsmanship and I agree to show good sportsmanship like conduct as a fan or volunteer. I also give my permission to the Irrigon Youth Basketball Program to give the above phone number to coaches, assistant coaches or those who have an immediate need. Finally, by my signature below I confirm that my child has permission to play in the above sport and I also confirm that I am the parent, guardian, or responsible party that can authorize the child’s participation in the above sport. In case of emergency, I hereby authorize a representative of Irrigon youth Basketball to seek emergency medical attention for my child. Parent/Guardian Signature(typed) (required) (required)

Date (required)