FRED ANDREWS
Please Circle Grade Level & Shirt Size K-2nd
3rd-4th
|
5th-6th
|
|
7th-9th
Player _____________________________Grade:____ Address _____________________________________
June 16-19 @ FCHS GYM Come Receive Instruction from
FRED ANDREWS New FCHS Boys Basketball Coach! Grades Are for Upcoming 2014-15 School Year
5th-6th K- 2nd 3rd-4th 7th-9th
7:30 – 9:00 p.m. . . . . . . . $40 9:00 – 10:00 a.m. . . . . . . $35 10:00 – 11:30 a.m. . . . . . .$40 11:30 a.m.-1:00 p.m. . . . $40**
**(7th-9th Weights 10:00 – 11:00 a.m.) Campers Receive: T-shirt & Certificate Family Discounts Available for More Than One Son. Call for More Information: 317.430.7464 Make Checks Payable to: FCBYB – Camp (Franklin County Boys Youth Basketball - Camp)
Mail Registration & Payment to: 1 Wildcat Lane, Brookville, IN 47012
FORMS DUE JUNE 2, 2014
_____________________________________________ Shirt: YS
YM
YL
AS
M
L
XL
XXL
XXXL
I/We, the parents of the above mentioned child, hereby give(s) my/our approval for his participation in any and all activities of the Franklin County Boys Youth Basketball Camp during the 2014 session. I/We hereby authorize the organizers and supervisors of the FCBYB Camp to act for me/us according to their best judgment in any emergency requiring medical attention. I/We assume all risks and hazards incidental to the conduct of the activities and transportation to and from the activities. I/We do further hereby release, absolve, indemnify, and hold harmless the FCBYB Camp, the organizers, the sponsors and the supervisors, any or all of them. In case of injury or illness to my/our child, I/we hereby waive all claims against the organizers, the sponsors, or any supervisors appointed by them. I/We likewise release from responsibility any person transporting my/our child to or from the activities. I/We will furnish a certified birth certificate copy for the above named candidate upon request from camp officials.
Mother (signature) _______________________________ Address _____________________________________ _____________________________________________ Phone ________________ Cell __________________ Email ________________________________________
Father (signature)________________________________ Address _____________________________________ _____________________________________________ Phone ________________ Cell __________________ Email ________________________________________
Emergency Contact Information Name ________________________________________ Relationship __________________________________
Phone __________________ Cell _________________
3rd-4th
|
5th-6th
|
|
7th-9th
Player _____________________________Grade:____ Address _____________________________________
June 16-19 @ FCHS GYM Come Receive Instruction from
FRED ANDREWS New FCHS Boys Basketball Coach! Grades Are for Upcoming 2014-15 School Year
5th-6th K- 2nd 3rd-4th 7th-9th
7:30 – 9:00 p.m. . . . . . . . $40 9:00 – 10:00 a.m. . . . . . . $35 10:00 – 11:30 a.m. . . . . . .$40 11:30 a.m.-1:00 p.m. . . . $40**
**(7th-9th Weights 10:00 – 11:00 a.m.) Campers Receive: T-shirt & Certificate Family Discounts Available for More Than One Son. Call for More Information: 317.430.7464 Make Checks Payable to: FCBYB – Camp (Franklin County Boys Youth Basketball - Camp)
Mail Registration & Payment to: 1 Wildcat Lane, Brookville, IN 47012
FORMS DUE JUNE 2, 2014
_____________________________________________ Shirt: YS
YM
YL
AS
M
L
XL
XXL
XXXL
I/We, the parents of the above mentioned child, hereby give(s) my/our approval for his participation in any and all activities of the Franklin County Boys Youth Basketball Camp during the 2014 session. I/We hereby authorize the organizers and supervisors of the FCBYB Camp to act for me/us according to their best judgment in any emergency requiring medical attention. I/We assume all risks and hazards incidental to the conduct of the activities and transportation to and from the activities. I/We do further hereby release, absolve, indemnify, and hold harmless the FCBYB Camp, the organizers, the sponsors and the supervisors, any or all of them. In case of injury or illness to my/our child, I/we hereby waive all claims against the organizers, the sponsors, or any supervisors appointed by them. I/We likewise release from responsibility any person transporting my/our child to or from the activities. I/We will furnish a certified birth certificate copy for the above named candidate upon request from camp officials.
Mother (signature) _______________________________ Address _____________________________________ _____________________________________________ Phone ________________ Cell __________________ Email ________________________________________
Father (signature)________________________________ Address _____________________________________ _____________________________________________ Phone ________________ Cell __________________ Email ________________________________________
Emergency Contact Information Name ________________________________________ Relationship __________________________________
Phone __________________ Cell _________________
