Join us on Saturday, February 22nd with Arthurine Burton and the Higher Ground Community Development Center’s FREE Responding to the Call: Basketball Camp. Help us bridge the gap between our first responders of the surrounding communities. SPACES ARE LIMITED! Please sign up below.

New Life Christian School of Excellence
1622 7th Ave N Bessemer AL 35020

For more information, please contact Nehemiah Horace via phone at (334) 614-2181 or via email at nhorace@dbcenter.org.

Camp Features

Basketball Skills • ACT Prep Information • Interaction with First Responders • T-Shirts • Refreshments

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Sign Up

Parent or Guardian's Full Name

Email

Phone Number

Participant's Full Name

Gender

School Grade

Shirt Size

Is this your first time at a Dream Big Center’s event?

Waiver

Participant's Full Name

Date of Birth

Gender

Age

Current Grade

School

Height

Weight

Position

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number

Email

Parent Guardian's Full Name

Emergency Contact's Name

Emergency Phone Number

Does your child have any illness/medical conditions he/she is currently being treated for?

If yes, what?

Is he/she currently taking medications?

(1) Medication, Dosage & Frequency

(2) Medication, Dosage & Frequency

(3) Medication, Dosage & Frequency

Does your child have any allergies?

If yes, please list.

LIABILITY: I am aware that participation in training sessions, camps, and/or all DB Hoops related activities has some inherent risks and injury can occur. On rare occasions these injuries can be serious. In consideration of my child being allowed to participate in these activities, I, the parent/guardian, assume the risk of all injuries and agree not to sue the Dream Big Center, Inc., directors, coaches, assistant coaches, or volunteers for any and all injuries caused by or resulting from participating in training sessions, camps, and all DB Hoops related activities. Your signature below gives the Dream Big Center, Inc. permission to seek medical care for your child and/or transport your child to/from medical facility and to share this information with medical personnel on your child’s behalf in case of an emergency.

PHOTO/VIDEO CONSENT: By signing this waiver, I also authorize the use of images of the above-named participant captured through video, photo, and digital camera, and/or audio to be used, reproduced, and/or published by the Dream Big Center, Inc. on website or advertising. I waive any rights of compensation or ownership to materials used, reproduced, and/or published pertaining to the image, likeness and/or voice of my child by the Dream Big Center, Inc.

EXPECTATIONS: All student athletes are expected to give their full mental, physical, and emotional attention and effort during training sessions, camps, and all DB Hoops related activities. Silence, attention, and active learning are required during all instructions given. As a representation of the Dream Big Center, Inc., respect and sportsmanship are demanded during all activities.

Today's Date

I, parent/guardian, agree that the information given above is correct and to the terms listed above.

Payment

Donations are not required but are always welcomed!
Thank You!
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