pick bball camp
PICKERINGTON HIGH SCHOOL NORTH
PANTHER BASKETBALL CAMP MONDAY JUNE 12 THURSDAY JUNE 15
2017
For Boys entering the 3rd through 8th grades
ONLY 125 SPOTS AVAILABLE
5:30-8:30PM
Pre-Register by mailing in your registration form with payment to: Pickerington High School North 7800 Refugee Rd. Pickerington, Ohio 43147 Attn: Coach J. Bates
PRE-REGISTRATION HIGHLY ADVISED $80 per student Includes an official PN Camp Jersey and Camp Souvenir Make checks or money orders payable to Pickerington High School North
Camp instructors will be the Pickerington North Boys Basketball Coaching staff and Players.
Questions? Please email [email protected]
IMPROVEMENT BEGINS WITH "I" Pickerington High School North \ 7800 Refugee Road \ Pickerington, OH 43147
PANTHER BASKETBALL CAMP REGISTRATION FORM CAMPER’S NAME: _____________________________________________________________ SCHOOL: __________________________________________ ENTERING GRADE: _______ ADDRESS: _____________________________________________________________________ CITY: _______________________________________ ZIP: ______________________________ PARENT/GUARDIAN: __________________________________________________________ PARENT/GUARDIAN EMAIL: ___________________________________________________ EMERGENCY PHONE NUMBER: ________________________________________________ JERSEY SIZE: ____________________ (please indicate ADULT or YOUTH)
RELEASE AND WAIVER (Must be signed by child and by parent/guardian in order to participate) I acknowledge that I have been properly advised, cautioned and warned by administrative personnel of PLSD that I am exposing myself to the risk of injury including, but not limited to, the risk of sprains, fractures, and ligament and or cartilage damage which could result in temporary or permanent, partial or complete impairment in the use of my limbs, brain damage, paralysis or even death. Having been so cautioned and warned, it is still my desire to participate in camp and do so with full knowledge and understanding of the risk of injury. Child’s Signature: _______________________________________________________________ Parent/Guardian Signature: _____________________________________________________ Date: __________________________________________________________________________
Pickerington High School North \ 7800 Refugee Road \ Pickerington, OH 43147
PANTHER BASKETBALL CAMP MONDAY JUNE 12 THURSDAY JUNE 15
2017
For Boys entering the 3rd through 8th grades
ONLY 125 SPOTS AVAILABLE
5:30-8:30PM
Pre-Register by mailing in your registration form with payment to: Pickerington High School North 7800 Refugee Rd. Pickerington, Ohio 43147 Attn: Coach J. Bates
PRE-REGISTRATION HIGHLY ADVISED $80 per student Includes an official PN Camp Jersey and Camp Souvenir Make checks or money orders payable to Pickerington High School North
Camp instructors will be the Pickerington North Boys Basketball Coaching staff and Players.
Questions? Please email [email protected]
IMPROVEMENT BEGINS WITH "I" Pickerington High School North \ 7800 Refugee Road \ Pickerington, OH 43147
PANTHER BASKETBALL CAMP REGISTRATION FORM CAMPER’S NAME: _____________________________________________________________ SCHOOL: __________________________________________ ENTERING GRADE: _______ ADDRESS: _____________________________________________________________________ CITY: _______________________________________ ZIP: ______________________________ PARENT/GUARDIAN: __________________________________________________________ PARENT/GUARDIAN EMAIL: ___________________________________________________ EMERGENCY PHONE NUMBER: ________________________________________________ JERSEY SIZE: ____________________ (please indicate ADULT or YOUTH)
RELEASE AND WAIVER (Must be signed by child and by parent/guardian in order to participate) I acknowledge that I have been properly advised, cautioned and warned by administrative personnel of PLSD that I am exposing myself to the risk of injury including, but not limited to, the risk of sprains, fractures, and ligament and or cartilage damage which could result in temporary or permanent, partial or complete impairment in the use of my limbs, brain damage, paralysis or even death. Having been so cautioned and warned, it is still my desire to participate in camp and do so with full knowledge and understanding of the risk of injury. Child’s Signature: _______________________________________________________________ Parent/Guardian Signature: _____________________________________________________ Date: __________________________________________________________________________
Pickerington High School North \ 7800 Refugee Road \ Pickerington, OH 43147
