{"id":819,"date":"2024-05-14T08:42:36","date_gmt":"2024-05-14T08:42:36","guid":{"rendered":"http:\/\/smartballsummercamp.com\/?page_id=819"},"modified":"2025-08-04T20:43:53","modified_gmt":"2025-08-04T20:43:53","slug":"2024-application-submission","status":"publish","type":"page","link":"http:\/\/smartballsummercamp.com\/?page_id=819","title":{"rendered":"2025 Application Submission"},"content":{"rendered":"<div class=\"wpforms-container wpforms-container-full wpforms-block wpforms-block-6981f530-b83c-4882-a495-286ff90fab6b\" id=\"wpforms-980\"><form id=\"wpforms-form-980\" class=\"wpforms-validate wpforms-form\" data-formid=\"980\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F819\" data-token=\"dafbfe64d7da13fef0f4b59a882d18d7\" data-token-time=\"1778839963\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-980-field_4-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-980-field_4\">Name <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-980-field_4\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][4][first]\" required><label for=\"wpforms-980-field_4\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-980-field_4-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][4][last]\" required><label for=\"wpforms-980-field_4-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-980-field_6-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-inline\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-980-field_6\">Check One:  <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-980-field_6\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-980-field_6_1\" name=\"wpforms[fields][6][]\" value=\"Male\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-980-field_6_1\">Male<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-980-field_6_2\" name=\"wpforms[fields][6][]\" value=\"Female\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-980-field_6_2\">Female<\/label><\/li><\/ul><\/div><div id=\"wpforms-980-field_28-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"28\"><label class=\"wpforms-field-label\" for=\"wpforms-980-field_28\">Returning Camper?<\/label><ul id=\"wpforms-980-field_28\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-980-field_28_1\" name=\"wpforms[fields][28][]\" value=\"Yes\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-980-field_28_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-980-field_28_2\" name=\"wpforms[fields][28][]\" value=\"No\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-980-field_28_2\">No<\/label><\/li><\/ul><\/div><div id=\"wpforms-980-field_5-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-980-field_5\">Street Address, City, Zip <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-980-field_5\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][5]\" required><\/div><div id=\"wpforms-980-field_15-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"15\"><label class=\"wpforms-field-label\" for=\"wpforms-980-field_15\">Parent\/Guardian Name (Mother &#8211; Occupation)  (required field) <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-980-field_15\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][15]\" required><\/div><div id=\"wpforms-980-field_14-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"14\"><label class=\"wpforms-field-label\" for=\"wpforms-980-field_14\">Parent\/Guardian Name (Father &#8211; Occupation)   (required field) <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-980-field_14\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][14]\" required><\/div><div id=\"wpforms-980-field_7-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-980-field_7\">Parent Email Address  (required field) <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-980-field_7\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][7]\" required><\/div><div id=\"wpforms-980-field_8-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-980-field_8\">Phone for Parent\/Guardian  (required field) <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"number\" id=\"wpforms-980-field_8\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][8]\" required><\/div><div id=\"wpforms-980-field_9-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-980-field_9\">Phone for Student  (required field) <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"number\" id=\"wpforms-980-field_9\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][9]\" required><\/div><div id=\"wpforms-980-field_10-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"10\"><label class=\"wpforms-field-label\" for=\"wpforms-980-field_10\">Birthdate (MM\/DD\/YYYY)  (required field) <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-980-field_10\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][10]\" required><\/div><div id=\"wpforms-980-field_23-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"23\"><label class=\"wpforms-field-label\" for=\"wpforms-980-field_23\">Medical Insurance Carrier<\/label><input type=\"text\" id=\"wpforms-980-field_23\" class=\"wpforms-field-medium\" name=\"wpforms[fields][23]\" ><\/div><div id=\"wpforms-980-field_24-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"24\"><label class=\"wpforms-field-label\" for=\"wpforms-980-field_24\">Doctor Name &amp; Phone Number<\/label><input type=\"text\" id=\"wpforms-980-field_24\" class=\"wpforms-field-medium\" name=\"wpforms[fields][24]\" ><\/div><div id=\"wpforms-980-field_25-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"25\"><label class=\"wpforms-field-label\" for=\"wpforms-980-field_25\">Emergency Contact Name, Phone Number, Relationship to Camper (required field) <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-980-field_25\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][25]\" required><\/div><div id=\"wpforms-980-field_11-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"11\"><label class=\"wpforms-field-label\" for=\"wpforms-980-field_11\">School Name &amp; School District  (required field) <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-980-field_11\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][11]\" required><\/div><div id=\"wpforms-980-field_12-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"12\"><label class=\"wpforms-field-label\" for=\"wpforms-980-field_12\">Grade Level  (required field) <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-980-field_12\" class=\"wpforms-field-small wpforms-field-required\" name=\"wpforms[fields][12]\" required><\/div><div id=\"wpforms-980-field_13-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"13\"><label class=\"wpforms-field-label\" for=\"wpforms-980-field_13\">  (required field) T-Shirt Size (All sizes are ADULT sizes, please specify: XS, S, M, L, XL, XXL) <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-980-field_13\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][13]\" required><\/div><div id=\"wpforms-980-field_16-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"16\"><label class=\"wpforms-field-label\" for=\"wpforms-980-field_16\">I certify that the above statements are accurate and true to the best of my knowledge.  In addition, I will follow the rules and regulations of the Ron Palmer Summer Basketball Camp\/Hoop Smart at all times.  If I am asked to leave the camp for behavior problems, I understand that monies are not refundable.  I agree to be filmed and photographed and to use digital technology to participate in this camp.  I understand that the Ron Palmer Summer Basketball Camp will strive to keep all personal information confidential.   <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-980-field_16\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][16]\" required><div class=\"wpforms-field-description\">Parent or Legal Guardian&#8217;s Signature &#038; Date   (required field)<\/div><\/div><div id=\"wpforms-980-field_29-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"29\"><label class=\"wpforms-field-label\" for=\"wpforms-980-field_29\">How did you hear about the camp?<\/label><ul id=\"wpforms-980-field_29\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-980-field_29_1\" name=\"wpforms[fields][29]\" value=\"School Flyer \/ Email\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-980-field_29_1\">School Flyer \/ Email<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-980-field_29_2\" name=\"wpforms[fields][29]\" value=\"Referral from Friend\/Family\/Coach\/Teacher\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-980-field_29_2\">Referral from Friend\/Family\/Coach\/Teacher<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-980-field_29_4\" name=\"wpforms[fields][29]\" value=\"Facebook\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-980-field_29_4\">Facebook<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-980-field_29_5\" name=\"wpforms[fields][29]\" value=\"Instagram\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-980-field_29_5\">Instagram<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-980-field_29_3\" name=\"wpforms[fields][29]\" value=\"Other\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-980-field_29_3\">Other<\/label><\/li><\/ul><\/div><div id=\"wpforms-980-field_30-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"30\"><label class=\"wpforms-field-label\" for=\"wpforms-980-field_30\">Please note how you heard about camp if not answered above.<\/label><input type=\"text\" id=\"wpforms-980-field_30\" class=\"wpforms-field-medium\" name=\"wpforms[fields][30]\" ><\/div><div id=\"wpforms-980-field_26-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"26\"><label class=\"wpforms-field-label\" for=\"wpforms-980-field_26\">Comments\/Questions\/Concerns  (Responses generally within 24 hours.  Please check your spam mailbox.)<\/label><textarea id=\"wpforms-980-field_26\" class=\"wpforms-field-medium\" name=\"wpforms[fields][26]\" ><\/textarea><\/div><div id=\"wpforms-980-field_27-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"27\"><label class=\"wpforms-field-label\" for=\"wpforms-980-field_27\">IMPORTANT: All campers must have a current application on file to attend camp.<\/label><input type=\"text\" id=\"wpforms-980-field_27\" class=\"wpforms-field-small\" name=\"wpforms[fields][27]\" ><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-field wpforms-field-hp\"><label for=\"wpforms-980-field-hp\" class=\"wpforms-field-label\">Comment<\/label><input type=\"text\" name=\"wpforms[hp]\" id=\"wpforms-980-field-hp\" class=\"wpforms-field-medium\"><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"980\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"http:\/\/smartballsummercamp.com\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F819\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-980\" class=\"wpforms-submit\" data-alt-text=\"Thank you for registering!\" data-submit-text=\"Sumbit Application\" aria-live=\"assertive\" value=\"wpforms-submit\">Sumbit Application<\/button><\/div><\/form><\/div>  <!-- .wpforms-container -->","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"_links":{"self":[{"href":"http:\/\/smartballsummercamp.com\/index.php?rest_route=\/wp\/v2\/pages\/819"}],"collection":[{"href":"http:\/\/smartballsummercamp.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/smartballsummercamp.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/smartballsummercamp.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/smartballsummercamp.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=819"}],"version-history":[{"count":8,"href":"http:\/\/smartballsummercamp.com\/index.php?rest_route=\/wp\/v2\/pages\/819\/revisions"}],"predecessor-version":[{"id":991,"href":"http:\/\/smartballsummercamp.com\/index.php?rest_route=\/wp\/v2\/pages\/819\/revisions\/991"}],"wp:attachment":[{"href":"http:\/\/smartballsummercamp.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=819"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}