ELITE CAMP
NOVA SOUTHEASTERN UNIVERSITY RELEASE OF LIABILITY AND INDEMNIFICATION
NOVA SOUTHEASTERN UNIVERSITY NSU Sharks Hoop School GIRLS’ BASKETBALL 2012 SUMMER CAMPS
THIS RELEASE OF LIABILITY AND INDEMNIFICATION (the “Release”) is executed by ___________________________________________________ whose address is ____________________________________________________________ in favor of NOVA SOUTHEASTERN UNIVERSITY, INC., a Florida not for profit corporation (the “University”), whose address is 3301 College Avenue, Fort Lauderdale, Florida 33314. For and in consideration of my child being allowed to participate in the _________________________________________________________________ (the “Activity”), and in full recognition and appreciation of the risks involved in the Activity, I as parent and/or legal guardian of _____________, do hereby release and forever discharge the University, its trustees, officers, agents, and employees (hereafter collectively called the “Releasees”), from any and all liability for any loss, damage or injury, including, death, that may be sustained or suffered by my child or by any property belonging to me or my child, while participating in the Activity. I agree to indemnify, defend and hold the Releasees harmless from any and all liability for any injury, claim, demand, action, damage, loss, liability, fine, penalty, cost or expense (including, without limitation, reasonable attorney’s fees) of every kind or nature asserted by any party against a Releasee or incurred by any Releasee and arising directly or indirectly from or in connection with my child’s participation in the Activity or any activities related thereto. The provisions of this paragraph shall survive the completion of the Activity. I acknowledge that my child’s participation in the Activity is purely voluntary and is in no way mandated by the University. I further acknowledge that the University does not carry any medical insurance that would cover any medical bills for injuries or illnesses resulting from my child’s participation. Consequently, I agree that I will be fully responsible to pay any such bills. For purposes of this Release, participation in the Activity shall include transportation to and from the homes of the participants and other transportation related to the Activity. I represent to the University that there are no health-related reasons or problems that preclude or restrict my child’s full and safe participation in the Activity. If an emergency and/or medical situation occurs and the UNIVERSITY CANNOT LOCATE EITHER PARENT/GUARDIAN, please identify EMERGENCY CONTACT(S). Include name, phone numbers (home, business and cell) and relationship: 1.___________________________________________________________________ 2.___________________________________________________________________ MEDICAL CONDITIONS AND INFORMATION Allergies: ____________________________________________________________________ ____________________________________________________________________
ELITE CAMP— Grades 3-12 Cost: $100 Dates: Monday, June 25 and Tuesday June 26 Times: 9am-5pm
Other Special Health Concerns/ Medical Conditions and Medicines (including dosage and any notes): ____________________________________________________________________ ____________________________________________________________________ PERMISSION TO TREAT I authorize and give my consent to any licensed health professional to provide reasonable, necessary medical treatment. This authorization is intended to include emergency treatment and procedures. I agree to assume all costs related to such treatment. I agree that if any portion of this document is held to be invalid or unenforceable by a court of competent jurisdic-tion, then the remaining portion shall nevertheless continue in full force and effect to the maximum extent permitted by law. I HAVE READ THIS DOCUMENT CAREFULLY, FULLY UNDERSTAND ITS CONTENTS, KNOW THAT IT IS LEGALLY BINDING, AND ACKNOWLEDGE THAT BY SIGNING BELOW I MAY RELEASE AND WAIVE CERTAIN LEGAL RIGHTS THAT I OTHERWISE MIGHT HAVE. ___________________________________________ Participant Name ___________________________________________ Participant Signature ___________________________________________ Parent and/or Legal Guardian’s Name ___________________________________________ Parent and/or Legal Guardian’s Signature (Required if participant under 18 years of age) ________________________________ Date
Mail this form along with a copy of your insurance card to: Brooklyn Kohlheim NSU Girl’s Basketball Hoop School 3301 College Avenue ASA Building Room 207 Ft. Lauderdale, FL 33314 Fax: (954)-262-3926 QUESTIONS? CALL Office: (954)-262-8221 Or email at [email protected]
DAY CAMP - Grades 1-8 Cost: $200 Dates: Monday, June 18—Thursday, June 21 Times: 9am—5 pm *Check-in on June 18th from 8-9am About the Camp:
CA NC
Sharks Hoop School Registration Form
ELL
Proper shooting fundamentals.
ED
Fundamental footwork for post and perimeter players. Defensive footwork and team concepts for man-to-man. Ball handling drills for the novice and advanced. Setting, reading and defending screens. Rebounding fundamentals. And much more fun! TEAM CAMP—High School and AAU Cost: $300 / Min. 5 games Dates: Friday, June 22, - Sunday, June 24 2012 Times: Friday and Saturday 10 am—8pm / Sunday 10am5pm *Check-in on June 22nd from 8-9am All players on the team must fill out our registration form and liability waiver. These forms and camp fees will be collected from the coach and submitted all together. About the Camp:
CA NC
ELL
ED
Teams will receive a minimum of five games. Tournament style will be set up on Sunday. ELITE CAMP—Grades 3-12 Cost: $100 Dates: Monday, June 25 and Tuesday June 26 Times: 9am—5pm *Check-in on June 25 from 8-9am About the Camp: Posts will work on footwork in the post, post defense, reading defense, rebounding, using your off-hand, passing out of the post, and much more! Perimeter players will work on reading screens to get your shot off, controlling conversion, floor leadership, ball handling drills, passing with both hands, situations and much more fun! Clinic Location All three clinic dates will be held at the Don Taft University Center Arena located at the center of Nova Southeastern University’s Main Campus. 3301 College Ave Ft. Lauderdale, FL 33314. *Map is located on back of this brochure. Meals Campers that attend the Day Camp or Elite Camp will receive a free catered lunch. We encourage campers with allergies, vegan or kosher meals to bring their own bagged lunch. A concession stand will be available at all camps for drinks and snacks.
Head Coach and Co-Director LeAnn Freeland Just finished her first season as head coach at Nova Southeastern University. From 2007-2011, she served as head coach at the University of Indianapolis. In her four seasons as head coach, the program amassed an 89-35 record (.718) and three straight NCAA appearances. In 2009-2010, the Greyhounds won 24 straight games and earned a #2 national ranking during the season. Coach Freeland is known as a great fundamental coach and camp director. The UIndy Girls’ Basketball camp at-tendance increased approximately 5-fold shortly after she took over the program in 2007. Prior to UIndy, Coach Freeland spent eight years as an assistant coach for Florida Gulf Coast University and the University of Southern Indiana. Coach Freeland helped both teams advance to the Elite 8, including a 2007 appearance in the National Championship game. Assistant Coach and Co-Director Brook Kohlheim Just finished her first season as an assistant at NSU. Helped guide UIndy women’s basketball for two seasons as an assistant coach under Coach Freeland Prior to UIndy, she was the head varsity girls’ basketball coach at Bishop Verot Catholic High School in Ft. Myers, Florida.
Camper’s Name ________________________________________ Date of Birth _______________________Grade (Fall 2012)______ Age _______Email Address_______________________________ Address______________________________________________ ____________________________________________________ Home Phone __________________________________________ Emergency Phone _______________________________________ Parent’s or guardian’s name________________________________ Insurance Company______________________________________ Circle one: Youth T-shirt size: L Adult T-shirt size: S M L XL Will you be needing after care? ($10/day) ____Yes ____ No Circle which camp: DAY TEAM:____________ ELITE Enclosed is payment for:$______ Circle: Cash Check Money Order How did you hear about NSU Women’s Basketball Camps?_______________________________________________ *Please include the participant’s name and camp for which she is registering on all checks or money orders. ** All NSU employees will receive a $25 discount. Payment of Fees Payment of fees may be made by personal check or money order made payable to Shark Hoop School. The required deposit and enrollment fees are listed above. The deposit of $50 and the completion of the registration form will ensure your space in the clinic. Complete payment of fees for the clinic must be made on the first day of the clinic. Swimming Pool The swimming pool will be available at all lunch hours. Please pack accordingly. After Care / Open Gym For campers who can’t find rides home, there will be open gym for one hour immediately following the conclusion of camp for $10/day. Out-of-town accommodations For campers that will be coming in from out of town. We encourage you to stay at the Courtyard Marriott– Plantation located at 7780 Southwest 6th Street Plantation, FL 33324. Contact Michalene Barton at (954) 6049183. Mail this form along with a copy of your insurance card to: Brooklyn Kohlheim NSU Girl’s Basketball Hoop School 3301 College Avenue ASA Building Room 207 Ft. Lauderdale, FL 33314 Fax: (954)-262-3926 QUESTIONS? CALL Office: (954)-262-8221 Or email at [email protected]
NOVA SOUTHEASTERN UNIVERSITY NSU Sharks Hoop School GIRLS’ BASKETBALL 2012 SUMMER CAMPS
THIS RELEASE OF LIABILITY AND INDEMNIFICATION (the “Release”) is executed by ___________________________________________________ whose address is ____________________________________________________________ in favor of NOVA SOUTHEASTERN UNIVERSITY, INC., a Florida not for profit corporation (the “University”), whose address is 3301 College Avenue, Fort Lauderdale, Florida 33314. For and in consideration of my child being allowed to participate in the _________________________________________________________________ (the “Activity”), and in full recognition and appreciation of the risks involved in the Activity, I as parent and/or legal guardian of _____________, do hereby release and forever discharge the University, its trustees, officers, agents, and employees (hereafter collectively called the “Releasees”), from any and all liability for any loss, damage or injury, including, death, that may be sustained or suffered by my child or by any property belonging to me or my child, while participating in the Activity. I agree to indemnify, defend and hold the Releasees harmless from any and all liability for any injury, claim, demand, action, damage, loss, liability, fine, penalty, cost or expense (including, without limitation, reasonable attorney’s fees) of every kind or nature asserted by any party against a Releasee or incurred by any Releasee and arising directly or indirectly from or in connection with my child’s participation in the Activity or any activities related thereto. The provisions of this paragraph shall survive the completion of the Activity. I acknowledge that my child’s participation in the Activity is purely voluntary and is in no way mandated by the University. I further acknowledge that the University does not carry any medical insurance that would cover any medical bills for injuries or illnesses resulting from my child’s participation. Consequently, I agree that I will be fully responsible to pay any such bills. For purposes of this Release, participation in the Activity shall include transportation to and from the homes of the participants and other transportation related to the Activity. I represent to the University that there are no health-related reasons or problems that preclude or restrict my child’s full and safe participation in the Activity. If an emergency and/or medical situation occurs and the UNIVERSITY CANNOT LOCATE EITHER PARENT/GUARDIAN, please identify EMERGENCY CONTACT(S). Include name, phone numbers (home, business and cell) and relationship: 1.___________________________________________________________________ 2.___________________________________________________________________ MEDICAL CONDITIONS AND INFORMATION Allergies: ____________________________________________________________________ ____________________________________________________________________
ELITE CAMP— Grades 3-12 Cost: $100 Dates: Monday, June 25 and Tuesday June 26 Times: 9am-5pm
Other Special Health Concerns/ Medical Conditions and Medicines (including dosage and any notes): ____________________________________________________________________ ____________________________________________________________________ PERMISSION TO TREAT I authorize and give my consent to any licensed health professional to provide reasonable, necessary medical treatment. This authorization is intended to include emergency treatment and procedures. I agree to assume all costs related to such treatment. I agree that if any portion of this document is held to be invalid or unenforceable by a court of competent jurisdic-tion, then the remaining portion shall nevertheless continue in full force and effect to the maximum extent permitted by law. I HAVE READ THIS DOCUMENT CAREFULLY, FULLY UNDERSTAND ITS CONTENTS, KNOW THAT IT IS LEGALLY BINDING, AND ACKNOWLEDGE THAT BY SIGNING BELOW I MAY RELEASE AND WAIVE CERTAIN LEGAL RIGHTS THAT I OTHERWISE MIGHT HAVE. ___________________________________________ Participant Name ___________________________________________ Participant Signature ___________________________________________ Parent and/or Legal Guardian’s Name ___________________________________________ Parent and/or Legal Guardian’s Signature (Required if participant under 18 years of age) ________________________________ Date
Mail this form along with a copy of your insurance card to: Brooklyn Kohlheim NSU Girl’s Basketball Hoop School 3301 College Avenue ASA Building Room 207 Ft. Lauderdale, FL 33314 Fax: (954)-262-3926 QUESTIONS? CALL Office: (954)-262-8221 Or email at [email protected]
DAY CAMP - Grades 1-8 Cost: $200 Dates: Monday, June 18—Thursday, June 21 Times: 9am—5 pm *Check-in on June 18th from 8-9am About the Camp:
CA NC
Sharks Hoop School Registration Form
ELL
Proper shooting fundamentals.
ED
Fundamental footwork for post and perimeter players. Defensive footwork and team concepts for man-to-man. Ball handling drills for the novice and advanced. Setting, reading and defending screens. Rebounding fundamentals. And much more fun! TEAM CAMP—High School and AAU Cost: $300 / Min. 5 games Dates: Friday, June 22, - Sunday, June 24 2012 Times: Friday and Saturday 10 am—8pm / Sunday 10am5pm *Check-in on June 22nd from 8-9am All players on the team must fill out our registration form and liability waiver. These forms and camp fees will be collected from the coach and submitted all together. About the Camp:
CA NC
ELL
ED
Teams will receive a minimum of five games. Tournament style will be set up on Sunday. ELITE CAMP—Grades 3-12 Cost: $100 Dates: Monday, June 25 and Tuesday June 26 Times: 9am—5pm *Check-in on June 25 from 8-9am About the Camp: Posts will work on footwork in the post, post defense, reading defense, rebounding, using your off-hand, passing out of the post, and much more! Perimeter players will work on reading screens to get your shot off, controlling conversion, floor leadership, ball handling drills, passing with both hands, situations and much more fun! Clinic Location All three clinic dates will be held at the Don Taft University Center Arena located at the center of Nova Southeastern University’s Main Campus. 3301 College Ave Ft. Lauderdale, FL 33314. *Map is located on back of this brochure. Meals Campers that attend the Day Camp or Elite Camp will receive a free catered lunch. We encourage campers with allergies, vegan or kosher meals to bring their own bagged lunch. A concession stand will be available at all camps for drinks and snacks.
Head Coach and Co-Director LeAnn Freeland Just finished her first season as head coach at Nova Southeastern University. From 2007-2011, she served as head coach at the University of Indianapolis. In her four seasons as head coach, the program amassed an 89-35 record (.718) and three straight NCAA appearances. In 2009-2010, the Greyhounds won 24 straight games and earned a #2 national ranking during the season. Coach Freeland is known as a great fundamental coach and camp director. The UIndy Girls’ Basketball camp at-tendance increased approximately 5-fold shortly after she took over the program in 2007. Prior to UIndy, Coach Freeland spent eight years as an assistant coach for Florida Gulf Coast University and the University of Southern Indiana. Coach Freeland helped both teams advance to the Elite 8, including a 2007 appearance in the National Championship game. Assistant Coach and Co-Director Brook Kohlheim Just finished her first season as an assistant at NSU. Helped guide UIndy women’s basketball for two seasons as an assistant coach under Coach Freeland Prior to UIndy, she was the head varsity girls’ basketball coach at Bishop Verot Catholic High School in Ft. Myers, Florida.
Camper’s Name ________________________________________ Date of Birth _______________________Grade (Fall 2012)______ Age _______Email Address_______________________________ Address______________________________________________ ____________________________________________________ Home Phone __________________________________________ Emergency Phone _______________________________________ Parent’s or guardian’s name________________________________ Insurance Company______________________________________ Circle one: Youth T-shirt size: L Adult T-shirt size: S M L XL Will you be needing after care? ($10/day) ____Yes ____ No Circle which camp: DAY TEAM:____________ ELITE Enclosed is payment for:$______ Circle: Cash Check Money Order How did you hear about NSU Women’s Basketball Camps?_______________________________________________ *Please include the participant’s name and camp for which she is registering on all checks or money orders. ** All NSU employees will receive a $25 discount. Payment of Fees Payment of fees may be made by personal check or money order made payable to Shark Hoop School. The required deposit and enrollment fees are listed above. The deposit of $50 and the completion of the registration form will ensure your space in the clinic. Complete payment of fees for the clinic must be made on the first day of the clinic. Swimming Pool The swimming pool will be available at all lunch hours. Please pack accordingly. After Care / Open Gym For campers who can’t find rides home, there will be open gym for one hour immediately following the conclusion of camp for $10/day. Out-of-town accommodations For campers that will be coming in from out of town. We encourage you to stay at the Courtyard Marriott– Plantation located at 7780 Southwest 6th Street Plantation, FL 33324. Contact Michalene Barton at (954) 6049183. Mail this form along with a copy of your insurance card to: Brooklyn Kohlheim NSU Girl’s Basketball Hoop School 3301 College Avenue ASA Building Room 207 Ft. Lauderdale, FL 33314 Fax: (954)-262-3926 QUESTIONS? CALL Office: (954)-262-8221 Or email at [email protected]
