NHA_Registration (click to download) Form to manually fill out and register. NHA_RegistrationPlease enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Housing Request for first 36 playersClick to Pick the 1st 36I need housing - $10 nightly fee and chaperone requiredI don't need housingStandby if someone drops outFirst come first served 36 spots available.Campers Name *FirstLastAgeDOBWeight lbs.Height Ft. In.Shirt SizeAddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeChurchPastorFather/GuardianMother/GuardianPhoneMedical Condition we need to be aware ofPhysical RestrictionsMedication InstructionsList of AllergiesDate of last Tetanus or BoosterInsurance Policy #Insurance CompanyEmergency ContactPhoneAcknowlegmentsACKNOWLEDGMENT OF RISK / WAIVER OF LIABILITY Iacknowledge and fully understand that I will be participating and engaging in activities that involve the risk of serious injury, including permanent disability, death, and severe social and economic losses. This may result from my own or other actions, inactions, or negligence, the rules of play, or the condition of the premises or any equipment used. I further acknowledge and understand that there may be other unknown risks not reasonably foreseeable at this time and agree to assume all the foregoing risks and accept personal responsibility for the damages following any such injury, permanent disability, or death, and hereby forever release discharge, and covenant not to sue and/or otherwise indemnify New Heights Basketball Camp, New Heights Athletics, Way of Life Baptist Church or Fellowship Baptist Church in Clayton, North Carolina, Beacon Baptist Church in Raleigh, North Carolina, their affiliated organizations and sponsors, coaches, managers, employees and associated personnel, officers, directors, agents, including the owners of premises used to conduct the camp from any and all liability to me, my heirs or next of kin for any and all against any claim by or on my behalf as a result of my participation in the New Heights Basketball Camp and/or transportation to or from the same. I hereby agree to individually provide for all present and possible future medical expenses that I may incur because of any injury sustained while participating at or for New Heights Basketball Camp. I acknowledge that I have health insurance and I will provide a photocopy of my valid insurance.Parent SignatureClear SignatureCampers SignatureClear SignatureEmail *Today's DateSubmit