Jan
    30
    Mah Jongg Game Days

    Join us for MahJongg Game Days ever Monday at The Village at Northridge. Bring your lunch!

  • Jan
    30
    The Hook Fundraiser

    Join us 4pm to 9pm for a fundraiser at The Hook. Dine in or take-out. 20% gets donated to VJCC and Today’s Montessori!

  • Feb
    02
    Exploring Broadway: Love Songs

    Join popular instructor James Sokol to explore the creative ways lyrics of love are expressed in a variety of melodies.

Basketball Camp Registration

Please fill in the form below for each child you would like to register for the Wayne Youth Basketball camp.

If you sign up for multiple sessions/weeks or a sibling, a 10% discount on each additional sessions/weeks or siblings will be applied later. 

"*" indicates required fields

Name*
MM slash DD slash YYYY
Parent 1 Name*
Parent 2 Name
Primary Policy Holder Name*
Emergency Contact Name*
Please select which options you would like to register for.
Hidden
Session Choices
Week 1 - July 11 - 15 @ A.E. Wright
Week 2 - July 18 - 22 @ A.E. Wright
Week 3 - August 8-12 @ Emek
Week 4 - August 15-19 @ Emek
Price: $0.00
Includes selections above and a 3% processing fee.
Credit Card
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Expiration Date
 
Billing Address*
PARENT PERMISSION FORM, LIABILITY WAIVER AND RELEASE, AND AUTHORIZATION FOR MEDICAL/DENTAL TREATMENT I understand that participation in the VJCC/Eclipse basketball camp involves risk and dangers of serious and permanent bodily injury and death. I hereby release, hold harmless, discharge and agree not to sue Eclipse basketball, Ben Yeger, the VJCC, all their affiliates and DBA, all directors, officers, employees, coaches, officials, volunteers, owners/leasers of premises for and from all liability from my participation in and with these and any other related travel, lodging, social and recreational activities. I also understand Eclipse basketball retains the right to use for publicity and advertising, photographs and video taken of the participants. I have given my son/daughter permission to participate in the VJCC/Eclipse Basketball events, and I certify that he is in good health, has been cleared by a physician and can take part in all physical activities not limited to, but including training, practices, and games. I am aware that my son/daughter may become injured. If an injury occurs, I authorize the staff members to take any action and use the emergency service available at the nearest hospital if necessary. I understand my personal insurance will be used in this case. In case of an emergency, I authorize the personnel to take action.
Name*
By typing your name below you are indicating you have read the above Parent Permission form, liability waiver, and release.
Medical Release**
Player Name*
By typing your name below you are indicating you have read the above Parent Permission form, liability waiver, and release.
Parents Code of Conduct**
Waiver**

Please click the submit button only once to avoid duplicate charges / submissions. Sometimes it takes a minute or two to process.
This field is for validation purposes and should be left unchanged.