basketball skills camp
2016 CAMP APPLICATION Session 1: July 19–22
Session 2: July 25–28
Please Print
M Camper’s name
BASKETBALL SKILLS CAMP
F
Gender (circle one)
Email Address City
State
(
AT ELMHURST COLLEGE
Zip
)
Home phone Birth date
Age at time of camp:
T-shirt size (circle one) child YS* YM YL *quantity limited
adult S
M
L
XL
XXL
Choose your Day Camp Session: V Session 1: July 19–22* FEE: $215 V S ession 2: July 25–28* FEE: $215 V Both Sessions* FEE: $395 * Sessions run from 8:30 a.m.–12:30 p.m. VE xtended Lunch Option:
12:30 p.m.–2:00 p.m. Lunch and Activity provided (sandwich, chips, dessert, drink) FEE: $75 Return with $100 deposit to: Hoop Haven 1151 S. Villa Avenue Villa Park, IL 60181 Please make checks payable to: Hoop Haven
• Deposits are non-refundable after July 1, 2016 • All sign-ups the week prior or day of the camp are $250 • Sign-ups close to July 1 may have a delay for a t-shirt and basketball or may be refunded the cost of the t-shirt/basketball
1151 S. Villa Avenue Villa Park, IL 60181
CAMP INFORMATION
ELMHURST COLLEGE
How did you hear about the camp? Repeat Camper Newspaper Ad Friend School Flyer around town
BASKETBALL SKILLS CAMP
Eleven years in the national rankings!
Day Camp Session 1: July 19–22 Session 2: July 25–28 8:30 a.m.–12:30 p.m. Skill development for all age groups
Boys and Girls Ages 4–14
CAMP STAFF John Baines John Baines is directing his 13th Skills Camp over the past 16 years. He, along with former head coach Mark Scherer, created this camp in 2001. Baines began his collegiate coaching career at Elmhurst in 2000-01. In his first year with the Bluejays, he helped the squad to a school-best 22–5 record and its first College Conference of Illinois and Wisconsin Championship. In Baines’ tenure at Elmhurst the Bluejays compiled a 174–107 record (.626 winning percentage), recorded five conference runner-up finishes, qualified for the CCIW Tournament six times, won over 20 games in five seasons and advanced to the NCAA Tournament four times. Coach Baines has been coaching college basketball for over 15 years. Chris Martin Martin is working his 13th Skills Camp in the past 14 years and is directing his fifth season as the assistant men’s basketball coach. As recruiting coordinator, Chris has been the lead recruiter on the first back-to-back 20-win season in school history. Prior to coaching for Elmhurst, Martin was the head coach of the Bayer Leverkusen Giants in the Professional B League in Germany. This follows his three-year professional playing career in Luxembourg and Germany where he was named 1st team allleague in each of those seasons.
DAY CAMP INFORMATION
CONSENT FORM
j Session j Session
Must be filled out and returned for camp attendance
1: July 19–22 2: July 25–28
8:30 a.m.–12:30 p.m. Optional Extended Lunch 12:30–2:00 p.m.
F
Gender (circle one)
Birth date
Specializing in girls and boys, ages 4–14 $215 Tuition—Limited Enrollment. Sign Up Early! • Separate Skill Development Groups • Professional Staff of Certified Teachers • Competition & Awards— Every Day • Free T-shirt & Basketball • Located at R.A. Faganel Hall (Elmhurst College)
Guardian’s Name
Yes No Allergies/Asthmas (circle one)
If yes, please describe
In case of emergency: Father’s Name
(
)
Home phone
(
)
Cell phone
Mother’s Name
(
)
Home phone
(
)
Cell phone
Insurance company
As a 2006 graduate of Elmhurst College, Martin was named to the All-America team twice; named on four College Conference of Illinois and Wisconsin’s (CCIW) all-conference squads and three straight first-team selections. He became just the second Bluejay in Elmhurst history to earn four all-conference honors in his career and the first to earn three first-team selections. He was inducted into the Elmhurst College Hall of Fame in 2011.
Policy #
Heather Furr Heather is working her 9th Skills Camp in a row. From Plainfield, IL, Heather played basketball, volleyball, softball, tennis and ran track in high school. She also played basketball and ran track at VALPO for two years before coming to Elmhurst College to finish her career. Heather graduated with her BA in elementary education. She started her career teaching 5th grade for two years in Plainfield and coaching girls high school basketball over those two seasons. She now lives in Wrigleyville and is a full time personal trainer for XSPORT Fitness and plays football for the Chicago Bliss (LFL Team).
M Player’s name
Questions? Call Chris Martin at (309) 339-9772 or email: cmartin@ elmhurst.edu
I, the undersigned, hereby certify that I am the legal guardian of the player. I hereby give my permission for the staff of Elmhurst College Basketball, during the duration of the camp, to seek appropriate medical attention for the player, for medical attention to be given and for the player to receive medical attention in the event of accident, injury or illness. I will be responsible for any and all costs of medical attention and treatment and have medical insurance to cover these costs. I, the undersigned, for myself and as a guardian of above named player, understand that basketball is an active, physical sport, and that injuries can take place during play. I also understand that there will be a number of other players attending the camp, there will be a limited number of staff and that our child cannot receive individualized attention and supervision all of the time. I understand that, as with any sport, injuries can occur, and we hereby acknowledge that our child is physically fit and mentally capable of participating in camp activities. I, the undersigned for myself, my heirs, executors and administrators, waive, release and forever discharge Elmhurst College Basketball, Elmhurst College, and its staff, officers, agents, representatives, successors, and assign of and from all rights and claims for damages, injury or loss to person or property which may be sustained or occur during participation in camp activities or while at the camp, whether or not damages, injury or loss due to negligence.
Signature of Parent/Guardian:
Session 2: July 25–28
Please Print
M Camper’s name
BASKETBALL SKILLS CAMP
F
Gender (circle one)
Email Address City
State
(
AT ELMHURST COLLEGE
Zip
)
Home phone Birth date
Age at time of camp:
T-shirt size (circle one) child YS* YM YL *quantity limited
adult S
M
L
XL
XXL
Choose your Day Camp Session: V Session 1: July 19–22* FEE: $215 V S ession 2: July 25–28* FEE: $215 V Both Sessions* FEE: $395 * Sessions run from 8:30 a.m.–12:30 p.m. VE xtended Lunch Option:
12:30 p.m.–2:00 p.m. Lunch and Activity provided (sandwich, chips, dessert, drink) FEE: $75 Return with $100 deposit to: Hoop Haven 1151 S. Villa Avenue Villa Park, IL 60181 Please make checks payable to: Hoop Haven
• Deposits are non-refundable after July 1, 2016 • All sign-ups the week prior or day of the camp are $250 • Sign-ups close to July 1 may have a delay for a t-shirt and basketball or may be refunded the cost of the t-shirt/basketball
1151 S. Villa Avenue Villa Park, IL 60181
CAMP INFORMATION
ELMHURST COLLEGE
How did you hear about the camp? Repeat Camper Newspaper Ad Friend School Flyer around town
BASKETBALL SKILLS CAMP
Eleven years in the national rankings!
Day Camp Session 1: July 19–22 Session 2: July 25–28 8:30 a.m.–12:30 p.m. Skill development for all age groups
Boys and Girls Ages 4–14
CAMP STAFF John Baines John Baines is directing his 13th Skills Camp over the past 16 years. He, along with former head coach Mark Scherer, created this camp in 2001. Baines began his collegiate coaching career at Elmhurst in 2000-01. In his first year with the Bluejays, he helped the squad to a school-best 22–5 record and its first College Conference of Illinois and Wisconsin Championship. In Baines’ tenure at Elmhurst the Bluejays compiled a 174–107 record (.626 winning percentage), recorded five conference runner-up finishes, qualified for the CCIW Tournament six times, won over 20 games in five seasons and advanced to the NCAA Tournament four times. Coach Baines has been coaching college basketball for over 15 years. Chris Martin Martin is working his 13th Skills Camp in the past 14 years and is directing his fifth season as the assistant men’s basketball coach. As recruiting coordinator, Chris has been the lead recruiter on the first back-to-back 20-win season in school history. Prior to coaching for Elmhurst, Martin was the head coach of the Bayer Leverkusen Giants in the Professional B League in Germany. This follows his three-year professional playing career in Luxembourg and Germany where he was named 1st team allleague in each of those seasons.
DAY CAMP INFORMATION
CONSENT FORM
j Session j Session
Must be filled out and returned for camp attendance
1: July 19–22 2: July 25–28
8:30 a.m.–12:30 p.m. Optional Extended Lunch 12:30–2:00 p.m.
F
Gender (circle one)
Birth date
Specializing in girls and boys, ages 4–14 $215 Tuition—Limited Enrollment. Sign Up Early! • Separate Skill Development Groups • Professional Staff of Certified Teachers • Competition & Awards— Every Day • Free T-shirt & Basketball • Located at R.A. Faganel Hall (Elmhurst College)
Guardian’s Name
Yes No Allergies/Asthmas (circle one)
If yes, please describe
In case of emergency: Father’s Name
(
)
Home phone
(
)
Cell phone
Mother’s Name
(
)
Home phone
(
)
Cell phone
Insurance company
As a 2006 graduate of Elmhurst College, Martin was named to the All-America team twice; named on four College Conference of Illinois and Wisconsin’s (CCIW) all-conference squads and three straight first-team selections. He became just the second Bluejay in Elmhurst history to earn four all-conference honors in his career and the first to earn three first-team selections. He was inducted into the Elmhurst College Hall of Fame in 2011.
Policy #
Heather Furr Heather is working her 9th Skills Camp in a row. From Plainfield, IL, Heather played basketball, volleyball, softball, tennis and ran track in high school. She also played basketball and ran track at VALPO for two years before coming to Elmhurst College to finish her career. Heather graduated with her BA in elementary education. She started her career teaching 5th grade for two years in Plainfield and coaching girls high school basketball over those two seasons. She now lives in Wrigleyville and is a full time personal trainer for XSPORT Fitness and plays football for the Chicago Bliss (LFL Team).
M Player’s name
Questions? Call Chris Martin at (309) 339-9772 or email: cmartin@ elmhurst.edu
I, the undersigned, hereby certify that I am the legal guardian of the player. I hereby give my permission for the staff of Elmhurst College Basketball, during the duration of the camp, to seek appropriate medical attention for the player, for medical attention to be given and for the player to receive medical attention in the event of accident, injury or illness. I will be responsible for any and all costs of medical attention and treatment and have medical insurance to cover these costs. I, the undersigned, for myself and as a guardian of above named player, understand that basketball is an active, physical sport, and that injuries can take place during play. I also understand that there will be a number of other players attending the camp, there will be a limited number of staff and that our child cannot receive individualized attention and supervision all of the time. I understand that, as with any sport, injuries can occur, and we hereby acknowledge that our child is physically fit and mentally capable of participating in camp activities. I, the undersigned for myself, my heirs, executors and administrators, waive, release and forever discharge Elmhurst College Basketball, Elmhurst College, and its staff, officers, agents, representatives, successors, and assign of and from all rights and claims for damages, injury or loss to person or property which may be sustained or occur during participation in camp activities or while at the camp, whether or not damages, injury or loss due to negligence.
Signature of Parent/Guardian:
