Basketball Performance

Phone:770-823-9831 Emailinfo@furyperformanceacademy.com Contact Form

Fury’s Basketball Performance will be from 5pm-6pm Tuesdays and Thursdays from July 7th-30th. This is the perfect opportunity for your athlete to develop the necessary skills to enhance their abilities, learn new techniques and become the best basketball player they can be. Your campers can expect to be challenged and participate in competitions throughout the camp.

Summer Basketball Performance

PAYMENT- *

LOCATION *

Payment Information

At the completion of this form you will be automatically redirected to PayPal for payment. You may pay utilizing your PayPal account, a debit or credit card. If you are unable to provide a credit/debit card online, you are welcome to send a check to Fury Performance at 202 Rope Mill Road, Suite B., Woodstock, GA 30188. Please make checks payable to Fury Performance and write your athlete’s name and grade on the check. You may also pay cash in person at Fury Performance. If you have any questions please call or text us at: 770.823.9831

Athlete Information

CAMPER’S LAST NAME *

CAMPER’S FIRST NAME *

CAMPER’S DATE OF BIRTH *

CAMPER’S CURRENT AGE *

Parent/ Guardian Information

PARENT’S LAST NAME *

PARENT’S FIRST NAME *

EMAIL ADDRESS *

PHONE NUMBER *

Pick-up Authorization

Please list the names of anyone else authorized to pick up your child at the end of camp. (Photo ID will be required at pickup)

Emergency Contact Information

Please name any contact other than the parent listed above to contact in the event of an emergency

Name *

Phone Number *

Waiver and Release of Liability

I understand that, in sports performance and football camps, there is always a risk of permanent or partial injury and/or disability. I hereby waive and release Fury Performance, the owner, employees, sponsors, and all participants directing their programs from any liability for injuries the student might incur while participating in the programs, camps, clinics, and training sessions. I certify by my signature below, that I know of no mental or physical problems that might affect the athlete’s ability to safely participate in the programs offered by Fury Performance. I further agree to be solely responsible for any medical or related expenses that arise from the athlete’s participation and/ or attendance in the programs offered by Fury Performance. I hereby authorize the coaches and/or instructors and/or management of Fury Performance to act for me in my absence according to their judgment in any emergency requiring medical attention.

Any Additional Notes for our Staff

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PROGRAM DETAILS

Summer Basketball Performance

Payment Information

Athlete Information

Parent/ Guardian Information

Pick-up Authorization

Emergency Contact Information

Waiver and Release of Liability

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