Name
Address
Email
Grade (next school year)
T-Shirts Size (youth) S M L (Adult) S M L XL
Scholarships are limited.
I would like to be considered for a scholarship, check yes
Medical Wavier
I hereby and herein authorize the Directors of the Bulldog Basketball Camp, or any agents working on their behalf, to act in my stead for the purpose of acquiring emergency medical attention for my son or daughter or ward. I impose upon the assumptions of this duty the responsibility to act with reasonable care and caution and release and waive all liability for any injuries and illness incurred while at the camp. By my signature hereunder, I warrant that my son and/or daughter or ward is in good physical condition, has no undisclosed medical problems, illnesses, or disabilities and is capable of full and active participation in the basketball camp.
I also represent that my son and/or daughter or ward has received a physical within the last year and is medically competent to participate in the activities at camp.
Signature of Parent and/or Guardian Date
Camp will be held at the Bryan Center Outdoor Courts. In case of inclement weather, we will use another gym. Location TBA at Camp.
YS Resident - $40.00
Non-YS Resident – $60.00
Camp fee includes: Bulldog t-shirt, basketball, water bottle, snacks, special prizes, guest speakers and lots and lots of teaching and fun.
SEND REGISTRATION FORM/FEE TO:
PO Box 406
Yellow Springs, Ohio 45387
