New Horizon Day Camp RegistrationAdmin2026-05-23T19:56:32-04:00 What Week/Day Are You Registering For? *Week of June 15th ($75)Week of June 22nd ($75)Week of July 6th ($75)Week of July 13th ($75)Week of July 20th ($75)Week of July 27th ($75)Week of August 3rd ($75)All 7 Weeks ($300)Daily ($25)For Daily Registration Only - What date are you requesting to register for?Email Address *Parent/Guardian's Name *Contact Number *Street Address *Apartment, suite, etcCity *State *ZIP / Postal Code *Child's Name *Child's Date Of Birth *MonthSelect month123456789101112DaySelect day12345678910111213141516171819202122232425262728293031YearSelect Year20242023202220212020201920182017201620152014201320122011201020092008200720062005Child's Gender *Select OneFemaleMaleEmergency Contact's Name *Emergency Contact's Number *Emergency Contact's Relationship to Child *Select OneParentGrandparentSiblingAunt/UncleFamily FriendOtherIs This Child Allergic to any MedicationsThis information is gathered for medical emergency use only.Does This Child Have any Medical History That you Feel we Should Know AboutThis information is gathered for medical emergency use only.Confidential InformationThe following information is confidential and will be used solely for future program and funding opportunities.Child Lives With *Both ParentsMother OnlyFather OnlyLegal GuardianRace/Ethnicity of Child *African AmericanAsianCaucasian/WhiteHispanicMulti-RacialAnnual Household Income Level *Less than $10,000$10,000 - $20,000$20,000 - $30,000$30,000 - $40,000$40,000 - $50,000$50,000 - $100,000More than $100,000Interested in Volunteer Opportunities with us? Please Check all That Apply.AdministrativeCoachingFinanceFundraisingLearning Lab TutorMarketing/CommunicationProgram AssistantRefereeingOtherTerms & ConditionsConsent and Release *I have read and accept the terms within the consent and release as outlined below. My child/legal ward has permission to participate in Premier Athletics for Youth Development programs. I hereby release and wave any and all claims against Premier Athletics for Youth Development and any agents, representatives, officers, board of directors, coaches, and other personnel of the same; from any responsibility of liability or liability for any injury, loss or damage which may hereafter be suffered or sustained by my child arising out of their playing or participating in this program. This includes but is not limited to competing in sports, traveling to or from any games/events, practice, or activities sponsored by Premier Athletics for Youth Development or while a spectator at any games, practices, or events. I authorize the head coach of my child’s team, Premier Athletics for Youth Development staff, or emergency personal to seek and/or provide medical attention for my child if I cannot be contacted.Model Photo Release *I have read and accept the terms within the Model Photo Release as outlined below. I, for good and valuable consideration, the receipt of which is hereby acknowledged, hereby irrevocably authorize Premier Athletics for Youth Development to use photographs of me, my child, and/or my property and authorize their assignees, licensees, legal representatives and transferees to use and publish (with or without me or my child’s name, company name, or with fictitious name) photographs, pictures, portraits or images herein described in any or all forms and media and in all manners including composite images or distorted representations, and the purposes of publicity, illustration, commercial art, advertising, publishing (including publishing in electronic form in DVDs or internet websites), for any product or services, or other lawful uses as may be determined by Premier Athletics for Youth Development. I further waive any and all rights to review or approve any uses of the images, any written copy or finished product. I am of full legal age and have read and fully understand the terms of this release. I am the parent or guardian of the minor named above. I have the legal rights to consent to and do consent to the terms and conditions of this model release.Credit / Debit Card Payment * SubmitPlease do not fill in this field.