registration form - Future Stars Youth Sports Camps

International Enterprises
BASIS Peoria has partnered with Future Stars to offer one of the most comprehensive and acclaimed archery programs in the Valley. Our programs pass on
the love of archery to students using a safe, fun and proven teaching method.
Whether you are a newcomer to the sport of a highly skilled archer, our level
three archery instructors will help to improve skills, understand safety protocols,
and become competition-ready.
Dates: Mondays and Fridays
March 24, 28, 31, April 4, 7, 11, 14, 18,
21, 25, 28 and May 2
Time: 4-5 p.m.
Cost: $199
Grades: 5th-12th
Location: BASIS Peoria, 25950 North Lake
Pleasant Parkway, Peoria, AZ 853833
For more information or to register, go to www.futurestarsbasis.com or call 623-326-4267
International Enterprises
BASIS Archery
TO REGISTER: Please fill out the information below and drop the form and
your payment off at the front desk of the school or call 623-566-9100.
How many children are you registering?_________________________________________
Child name(s):_____________________________________________________________
Child age(s):____________ Child gender(s):______________________________________
T-shirt size(s) (s, m, l, xl, xxl): _________________________________________________
Parent name: ______________________________________________________________
Email address:_____________________________________________________________
Phone number: ____________________________________________________________
Referral Program: Our customers love our FSIE Referrals Program almost as much as we
do. They keep earning referral rewards, and we keep attracting great customers. For each
successful referral you will earn $10.00.
Do you have a referral?______________________________________________________
WAIVER: I agree that in case of an accident involving my child while attending this clinic, academies, or leagues,
and with full awareness that summer camps, sports programs and activities that may involve risk, or injury, I release
FSIE LLC, its coaches and assistants, from any and all liability. I understand every precaution will be taken to provide a safe environment and I authorize the FSIE LLC; coaching staff to account for me according to their best
judgment in the event my child needs emergency medical attention. I hereby authorize FSIE LLC coaches and/or
medical personnel to administer any necessary first aid. I accept any and all expenses that maybe incurred resulting
from emergency medical treatment.
Returned check policy. Future Stars has a no refunds on registration form. Future stars has a no refund policy,
however we reserve the right to evaluate eligibility for refund or partial refund eligibility on a case to case basis. In
the case of returned checks you will be charged a $25 fee for any returned checks.
Appearance Agreement; I understand that FSIE LLC from time to time produces promotional material relating to
its programs. I understand that as a participant in and/or a spectator at the Clinic, Minor may be included in videotapes, photographs, DVD’s, Podcasts and video casts taken during the clinic. Therefore, without reservation or
limitations, I, in my own behalf and on behalf of the Minor, hereby assign, transfer and grant to and FSIE LLC its
successors, assignees, licensees, sponsors, any television networks, and all other commercial exhibitors the exclusive right to photograph and/or videotape Minor and to utilize such videotapes and photographs and Minor’s
name, face, likeness, voice and appearance as part of the Clinic, academy or league, in advertising and promoting
the FSIE programs or in advertising and promoting similar future events. I further understand that neither FSIE
LLC nor any third party is under any obligation to exercise any of the foregoing rights, licenses and privileges. I,
in my own behalf and on behalf of the Minor, waive any right to inspect or approve any materials related thereto.
Signature: ________________________________________________________________