2025 MARCH BREAK CAMP Registration Form

2025 MARCH BREAK CAMP Registration Form
Monday to Friday

March 10-14th, 2025

Grades: 1 to 5

Hours: Full Day (9AM to 3PM) | Half Day: (9AM to 12PM) or (12PM to 3PM)

Location: B-Ballerz Academy (13495 Bathurst St. Richmond Hill)

Fees:

- Half Days = $297 plus tax (Monday to Friday 9am-12pm or 12-3pm)

- Full Days = $397.00 plus tax (Monday to Friday 9am-3pm)

- Before (8-9am) and/or After (3-4pm) Care Available Upon Request

*Don't forget your indoor playing shoes & water bottle.

- Please provide your athlete with lunch and snacks.

*No lunch required for Friday March 14th (Pizza will be served).

*Sibling Discount: 10% off for second child.

Limited Spots
Parent Information

Please complete your information below:
Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityProvince

Postal code
Phone number*
Athlete information
First and Last Name*
Date of Birth*

MonthDayYear
Medical Information

Please outline any medical information, allergies, caring or special requirements below for your child.
Please indicate details below
Emergency Contact

Please provide the details of another adult who can be contacted in case of emergency
Name*

First NameLast Name
Contact number*
Responsibilities:
- To waive all claims that I have or may have in the future against B-Ballerz Athletic Academy/UJAM, its members, employees, volunteers, and independent contractors (all of whom are hereinafter collectively referred to as “B-Ballerz Athletic Academy/UJAM”).
- To release B-Ballerz Athletic Academy/UJAM from any and all liability for any loss, damage, injury, or expense that I may suffer, or that my next of kin may suffer as a result of my participation in all activities, due to any cause whatsoever including negligence, breach of contract, or breach of a statutory or other duty of care.
- Please ensure all children's belongings are clearly labelled with their name.
- To hold harmless and indemnify B-Ballerz Athletic Academy/UJAM from any and all liability for any damage to the property of, or personal injury to, any third party resulting from my participation in all activities.
- This agreement shall be effective and binding upon my heirs, next of kin, executors, administrators, assigns, and representatives in the event of my death or incapacity.
- I, the undersigned, hereby authorize B-Ballerz Athletic Academy/UJAM to photograph, take motion pictures of, take video footage, and/or make electronic sound recordings. I understand that these pictures and/or videos may be posted on B-Ballerz Athletic Academy’s/UJAM's social media accounts including Facebook, Instagram, and other accounts.
I give my consent to B-Ballerz Academy/UJAM staff/coaches to supervise my child on outdoor walks near the gym, including parks, playgrounds and other outdoor facilities.*

I understand
I have read and understood this agreement and I am aware that by signing this agreement I am waiving certain legal rights which I, or my heirs, next of kin, executors, administrators, and assigns may have against B-Ballerz Athletic Academy/UJAM.*

I understand
NO OUTDOOR SHOES ALLOWED IN THE GYM. All outdoor shoes must be removed. I understand that my child can only participate with appropriate Indoor Athletic/Training shoes. (We encourage kids to change into their shoes at the gym).*

I understand
I authorize B-Ballerz Athletic Academy/UJAM to charge my credit card provided on my account for service purchased.*

I agree
In addition to giving this full consent for my child's participation, I do hereby agree to waive any claims and/or rights that I might otherwise sue B-Ballerz Athletic Academy, its admins, directors, shareholders, employees, agents and all others associated with the corporation from all liability for any and all damages and/or injuries that might occur as a result of these activities.*

I agree

Payment*

Basketball Day Camps

$297.00CAD

Enter coupon

Subtotal

$0.00CAD

Tax

$0.00CAD

Total

$0.00CAD

Payment Methods

Credit Card

Apple Pay

Signature*

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2025 MARCH BREAK CAMP Registration Form

Parent Information

Athlete information

Medical Information

Emergency Contact

Payment Methods