2025 Summer Camp Form

Registration Information: TUSC365 Summer Camp 2025

Camper Name

First Name

Last Name

Which session / option are you registering for?

If you'd like to register for more than one session (yay!), or if you have additional family members signing up, please complete a separate registration in each case. Thank you!

Parent Name

First Name

Last Name

Parent Email

Parent Phone

(###)

###

####

Parent #2 Name (optional)

First Name

Last Name

Parent #2 Email (optional)

Parent #2 Phone (optional)

(###)

###

####

Camper Email (optional)

Camper Date of Birth

YYYY

Camper Grade

What grade will this camper be entering in FALL 2025?

Requested Jersey Size

Please select your preferred jersey size (for the person attending camp). Sizes range from Youth Small to Adult XL. We'll do our very best to fulfill your first request, or as close to it as possible!

School

Where will this camper attend school in FALL 2025?

Ultimate Experience

Please describe your Ultimate experience. We'll be using this information to arrange appropriate groupings, so be as specific as you can!

Gender (optional)

Friends/Teammates at Camp (optional)

Will you be attending camp with any friends, teammates, or family members with whom you'd like to be grouped? We'll do our best to honor these requests, but it may not be possible in all cases.

Roommate Request(s)

OVERNIGHT CAMPERS ONLY. Note that we'll do our best to accommodate your requests, if you have them, but we can't guarantee your first choice. Rooms are typically "doubles," in which campers share a dorm room with one other player. Contact tusculti@gmail.com with any specific roommate-related questions or circumstances.

How Did You Hear About TUSC365 Summer Camp?

Elite Division Application

Would you like to apply for our Elite Division at camp this summer? If so, select "yes" below and we'll send you the materials to submit an application! [See our FAQs page for information about this option. Please note that this option is only available for rising 10th, 11th, and 12th graders.]

Yes

Emergency Contact

First Name

Last Name

Emergency Contact Phone

(###)

###

####

Medical Considerations

Do you have any specific medical conditions or concerns that we should be aware of during camp? Please share any pertinent medical history or needs here:

Insurance Company Name

Insurance Company Phone

(###)

###

####

Who is the primary carrier named on the camper's insurance?

First Name

Last Name

Preferred Hospital

In case of an emergency, which is your preferred hospital?

Liability Waiver

This acknowledges that we, the undersigned, parent(s) or legal guardian(s), recognize the potentially hazardous nature of the sport of Ultimate that an injury may be sustained. These injuries include, but are not limited to, PERMANENT DISABILITY, BLINDNESS, PARALYSIS and DEATH. In the event of such injury to the participant and we (I or my spouse or guardian) cannot be contacted, we give permission to qualified and licensed EMTs, physicians, paramedics, and/or other medical or hospital personnel to render appropriate treatment. We (I) release the 2025 Texas Ultimate Summer Camp, its employees, its agents, its volunteers and its assigns from any personal injuries caused by or having any relation to this activity. We (I) understand that this release applies to any present or future injuries or illnesses and that it binds my heirs, executors and administrators. I hereby authorize the Texas Ultimate Summer Camp to photograph and record my child’s likeness and participation for use in the above programming or parts thereof, including publication on the internet, published documents, and any other advertisements or promotional materials. This release form is complete and signed of my own free will and with full knowledge of its significances. I have read and understand all of its terms.

I acknowledge that I have read and agree to the TUSC365 Liability Waiver.

I do NOT agree to the TUSC 365 Liability Waiver.

Thank you for registering for TUSC Summer Camp 2025! Do you have any questions, concerns, or suggestions for Coach Kepner and the TUSC Staff?