DO YOU HAVE WHAT IT TAKES?
PLAYER REGISTRATION
AND
BIOGRAPHY
LAST NAME:

FIRST NAME:

NICKNAME:
AGE:                                                          DATE OF BIRTH
HEIGHT                                                           WEIGHT
GRADE                        SCHOOL                       GRADUATION YEAR
ADDRESS:

CITY:

STATE:

ZIP CODE

PHONE #:

EMAIL:

TRAVEL/AAU
TEAM:

FAVORITE
ATHLETE:

HOBBIES:





POSITION:
T-SHIRT SIZE           UNIFORM TOP         UNIFORM BOTTOM
INSURANCE CARRIER:


POLICY #:


GROUP #:
In case of emergency
please contact:

NAME:

RELATIONSHIP TO
PLAYER:

PRIMARY PHONE #:

SECONDARY PHONE #:
I, the undersigned, consent that my son is physically fit and
able to participate in strenuous activity and hereby waive New
England Regional adidas Phenom Camp and City Legends of
all responsibility for illness or injury sustained.  I hereby
authorize camp personnel and/or directors to act on my behalf
in the event of a medical emergency.  I understand that I am
solely responsible for payment of all medical expenses.

I waive all financial claims and understand that all photos and
videos taken during the camp are the property of the New
England Regional adidas Phenom Camp and may be used for
promotional use.  

I also understand that my payment is non-refundable and
non-transferable under any circumstances.
I consent to the disclaimer as stated above.
ADDITIONAL COMMENTS
Required:  Send (upload) a clear head shot photo of
individual player to info@nephenom.com  Please
include name, high school, year of graduation, city and state.




Email: info@nephenom.comemail
New England Regional
Adidas Jr Phenom Camp Session 3

Upcoming Camp November
2008

Date: TBA

Location: TBA






Who: 4th,5th, 6th, 7th, 8th and 9th
40 players maximum in each division


Payment info:
CLICK TO PAY NOW

No Personal Checks

Money orders or Bank checks
payable to:           
Phenom Basketball

Mail Payment to:
Phenom Basketball
2730 Washington St.
Roxbury, MA 02119

Additional Required Information:

Copy of report card or school ID

Individual head shot photo of
player (digital image sent via
email is preferred)

Biography form


For additional information and questions please feel free to contact
us: