NEVADA UNION BASKETBALL CAMP JUNE 24-27

Miner Basketball Camp

June 24-27, 2013

10 am-12:30 PM

Coaching Staff Includes

Nevada Union’s Basketball Staff

Local Middle School Coaches

Nevada Union’s Varsity Team

Areas of Emphasis

Footwork

Balance

Shooting skills

Teamwork

Special Features

Free T-Shirt

Individual Instruction

Top Notch Coaching and Evaluation

CAMP SPACE IS LIMITED …SIGN UP NOW

_____________________________________________________

Camp Application

Name _________________________________ T-Shirt Size (Men’s) S M L XL

Address ________________________________________________________________

City ____________________________________ State _______ Zip ________________

Phone# (Home) _______________________ (Work)_____________________________

Age ______________________ Grade as of August 2013________________________

Insurance Carrier _________________________________________________________

List any restrictions or other pertinent medical information, including any allergies to food or drugs_________________________________________

I/we agree to assume all risk of injury and to hold Nevada Joint Union High School District, their agents and employees, the camp directors and staff, harmless from any liability which may arise in connection with the clinic. I/we represent that I/we have health coverage for the participant, as indicated below. I/we grant permission to camp directors for emergency medical treatment/hospitalization if necessary.

I have read and understand this agreement:

Parent/Guardian ____________________________________ Date ________________

Insurance Company: ______________________________ Policy # ________________

MAKE CHECK PAYABLE TO: Nevada Union Boys’ Basketball

MAIL TO: Miner Basketball, 11761 Ridge Road, Grass Valley, CA 95945