2015 Boys Basketball Skills Clinic
Clinic Registration Form Name ________________________________________ Address ______________________________________ City __________________ State _____ Zip__________ Telephone (H)_ ________________ (w) ____________ Age ____ Grade in 2014-2015______ Ht _____ Wt _____
Tim Fusina completed his first season as head coach of the Centenary College men's basketball team in 2013-14.
Parent(s) Name(s) ______________________________ Parent Contact Number (c) ________________________
Fusina's first Centenary squad posted a 7-18 overall record, including 6-12 in CSAC play. The Cyclones earned their fifth-straight winning home mark, compiling a record of 7-5 in Hackettstown. Under Fusina's guidance, Centenary ranked second in the league in scoring defense (68.6 ppg) and tied for third in field goal percentage defense (.423).
AAU Team ____________________________________ Please check the clinic(s) you will be attending: ____January 11th - Clinic I – 5-8pm ____January 25th - Clinic II – 1-4pm Parent’s Signature ___________________________
_
Email Address:_______________________________ Price: Clinic I- $50.00 Clinic II- $50.00 Both Clinics- $75.00 total *Please make checks payable to: Centenary College (Memo line: Boys Basketball Clinic) Payment is non-refundable * Please return application & other fees to: Centenary College Boys Basketball Clinic 400 Jefferson Street Hackettstown, NJ 07840 *PAYMENT MUST BE CHECK, OR CASH.
From 2008-2013, Fusina served as the assistant men’s basketball coach at Washington & Jefferson College. He helped guide W&J to one of the most successful periods in program history as the Presidents claimed the 2009 ECAC South Region championship and earned 20 victories for just the second time in team history during his tenure. Under Fusina’s tutelage, five of his players garnered all-conference accolades. Prior to arriving at Washington & Jefferson, Fusina spent two seasons as an assistant coach at the University of Pittsburgh-Greensburg. At UPG, he coordinated recruiting and prepared scouting reports, while aiding in game planning and preparation. A native of Charleroi, Pa., Fusina earned his bachelor’s (2007) and master’s (2008) degrees in sport management from California University of Pennsylvania. Fusina is a member of the National Association of Collegiate Basketball Coaches (NABC). In addition to his collegiate coaching experience, he has also served as an instructor at numerous summer basketball camps.
2015 Boys Basketball Skills Clinic Clinic I January 11th 6-8pm Clinic 2 Jan. 25th 1-3pm
General Clinic Information
MEDICAL RELEASE FORM I herby give permission for ______________________to participate in the 2015 Centenary College Boys Basketball Clinic. I certify that my son is in good physical condition, has been examined within the last 12 months and no medical reason has been found that he can not participate in this clinic. Records show that all immunizations are up to date. I understand that he will be participating in rigorous play and activity. Centenary College Personnel have also been informed of any physical limitations, medications or prior conditions. The clinic will safeguard the health of my child but will not be responsible for accidents, injuries or sickness on the way to the clinic, during the clinic or on the way home.
It is important that players arrive in a timely fashion in order for the clinics to start and end on time. It is also imperative that players are picked up in a timely fashion once each clinic is done.
Coaches and players of the Cyclone Men’s Basketball team along with other experienced High School and College coaches will make up an energetic staff that will be sure to provide instruction that is second to none and an experience that your child will always remember.
Players may arrive 30 minutes prior to the start of the clinics to shoot around
Core Skills will be worked on in each clinic to improve each players game.
There will be fun within a framework of discipline in a positive, encouraging environment for your child to excel.
Call: Tim Fusina, Head Basketball Coach at 908-852-1400 ext. 2199 or e-mail at [email protected]
I agree that in the case of an accident involving my child while attending this clinic, and with full awareness that basketball is an activity that may involve risk or injury, I release Centenary College and the staff of Centenary College Boys Basketball Clinic from any and all liability. I herby request that my child be granted admittance into the 2014-15 Centenary College Boys Basketball Clinic and authorize the directors to act on my behalf in the event of an emergency requiring medical attention. I will assume responsibility for payment for any such attention and have provided current insurance information as requested. Player’s Name __________________________Age_____ Parent(s) Name(s) ______________________________
2015 Basketball Clinics
Parent(s) Daytime Phone ________________________
Clinic I Sunday, January 11th 6:00pm - 8:00pm $50.00
Home Phone ____________________________________ Emergency Contact ______________________________
Relationship __________Contact Phone# ____________ Insurance Carrier_______________________________
Clinic II Sunday, January 25th 1:00pm - 3:00pm $50.00 REGISTER FOR BOTH CLINICS $75.00
Detach Here
The Cyclone Basketball Clinics are designed for boys between the ages of 7—15 years old. Clinics will be held in the Gymnasium at the Reeves Student Recreation Center on the Centenary College campus.
Policy #_______________________________________ Previous Medical Conditions _______________________ By Signing below, I agree to all the terms detailed above Parent/Guardian Signature ________________________
www.centenarycyclones.com
Date_______________
Tim Fusina completed his first season as head coach of the Centenary College men's basketball team in 2013-14.
Parent(s) Name(s) ______________________________ Parent Contact Number (c) ________________________
Fusina's first Centenary squad posted a 7-18 overall record, including 6-12 in CSAC play. The Cyclones earned their fifth-straight winning home mark, compiling a record of 7-5 in Hackettstown. Under Fusina's guidance, Centenary ranked second in the league in scoring defense (68.6 ppg) and tied for third in field goal percentage defense (.423).
AAU Team ____________________________________ Please check the clinic(s) you will be attending: ____January 11th - Clinic I – 5-8pm ____January 25th - Clinic II – 1-4pm Parent’s Signature ___________________________
_
Email Address:_______________________________ Price: Clinic I- $50.00 Clinic II- $50.00 Both Clinics- $75.00 total *Please make checks payable to: Centenary College (Memo line: Boys Basketball Clinic) Payment is non-refundable * Please return application & other fees to: Centenary College Boys Basketball Clinic 400 Jefferson Street Hackettstown, NJ 07840 *PAYMENT MUST BE CHECK, OR CASH.
From 2008-2013, Fusina served as the assistant men’s basketball coach at Washington & Jefferson College. He helped guide W&J to one of the most successful periods in program history as the Presidents claimed the 2009 ECAC South Region championship and earned 20 victories for just the second time in team history during his tenure. Under Fusina’s tutelage, five of his players garnered all-conference accolades. Prior to arriving at Washington & Jefferson, Fusina spent two seasons as an assistant coach at the University of Pittsburgh-Greensburg. At UPG, he coordinated recruiting and prepared scouting reports, while aiding in game planning and preparation. A native of Charleroi, Pa., Fusina earned his bachelor’s (2007) and master’s (2008) degrees in sport management from California University of Pennsylvania. Fusina is a member of the National Association of Collegiate Basketball Coaches (NABC). In addition to his collegiate coaching experience, he has also served as an instructor at numerous summer basketball camps.
2015 Boys Basketball Skills Clinic Clinic I January 11th 6-8pm Clinic 2 Jan. 25th 1-3pm
General Clinic Information
MEDICAL RELEASE FORM I herby give permission for ______________________to participate in the 2015 Centenary College Boys Basketball Clinic. I certify that my son is in good physical condition, has been examined within the last 12 months and no medical reason has been found that he can not participate in this clinic. Records show that all immunizations are up to date. I understand that he will be participating in rigorous play and activity. Centenary College Personnel have also been informed of any physical limitations, medications or prior conditions. The clinic will safeguard the health of my child but will not be responsible for accidents, injuries or sickness on the way to the clinic, during the clinic or on the way home.
It is important that players arrive in a timely fashion in order for the clinics to start and end on time. It is also imperative that players are picked up in a timely fashion once each clinic is done.
Coaches and players of the Cyclone Men’s Basketball team along with other experienced High School and College coaches will make up an energetic staff that will be sure to provide instruction that is second to none and an experience that your child will always remember.
Players may arrive 30 minutes prior to the start of the clinics to shoot around
Core Skills will be worked on in each clinic to improve each players game.
There will be fun within a framework of discipline in a positive, encouraging environment for your child to excel.
Call: Tim Fusina, Head Basketball Coach at 908-852-1400 ext. 2199 or e-mail at [email protected]
I agree that in the case of an accident involving my child while attending this clinic, and with full awareness that basketball is an activity that may involve risk or injury, I release Centenary College and the staff of Centenary College Boys Basketball Clinic from any and all liability. I herby request that my child be granted admittance into the 2014-15 Centenary College Boys Basketball Clinic and authorize the directors to act on my behalf in the event of an emergency requiring medical attention. I will assume responsibility for payment for any such attention and have provided current insurance information as requested. Player’s Name __________________________Age_____ Parent(s) Name(s) ______________________________
2015 Basketball Clinics
Parent(s) Daytime Phone ________________________
Clinic I Sunday, January 11th 6:00pm - 8:00pm $50.00
Home Phone ____________________________________ Emergency Contact ______________________________
Relationship __________Contact Phone# ____________ Insurance Carrier_______________________________
Clinic II Sunday, January 25th 1:00pm - 3:00pm $50.00 REGISTER FOR BOTH CLINICS $75.00
Detach Here
The Cyclone Basketball Clinics are designed for boys between the ages of 7—15 years old. Clinics will be held in the Gymnasium at the Reeves Student Recreation Center on the Centenary College campus.
Policy #_______________________________________ Previous Medical Conditions _______________________ By Signing below, I agree to all the terms detailed above Parent/Guardian Signature ________________________
www.centenarycyclones.com
Date_______________
