HCYP Spring Break Basketball Camp 2016 ! ! ! !
HCYP Spring Break Basketball Camp 2016 ! ! ! ! Directed by Coach Kevin McDuffie “Keep It About the KIDS!™”
Place: Date: Time:
Girls & Boys Age 5 – 14
Centennial High School (4300 Centennial Lane, Ellicott City) March 28 – April 1, 2016 9:00 – 3:30
EACH PLAYER RECIEVES • Team T Shirt • Achievement Award COST: $200.00
PLUS: *Experienced Coaches
Before & After Care Available: Before & After care $50 for the week (Pay onsite or add-to fee for mail-in) Before Care 8-9am After Care 3:30 -5:00pm For Further Information contact: Coach McDuffie : [email protected] or 443-474-4211 HCYP WEBSITE: www.hcyp.org
Name: ________________________________________________________________________________________________________________________ Home Address:_______________________________________________________________________________________________________________ Email:________________________________________________________ _________Phone_________________________________________________ Before Care Y_____ N _____ After Care Y _____ N ______ Both Y______ N _______
* Nut Allergy Y______ N _______
School Name:_________________________________________________________________________Age ________Shirt Size_________________ Parent/ Guardian Name:_____________________________________________________________________________________________________________________ Will camper be taking medication during camp? Yes_______ No____ if yes please explain: I hereby register the above camper/campers as a participant in the basketball program. I certify that I am the parent/ legal guardian of the said camper/campers and hold harmless the HCYP Inc., from any and all liability for any injury, illness or condition that may arise as a result of participation in this program. I also certify that the above camper/campers birth date / age is accurate as indicated. ___________________________________________________________________________________________________ Date:________________________________________ Signature of Parent/Guardian
Mail application/ check payable to: HCYP - Spring Break Basketball Camp 2016 HCYP, Inc. P.O. Box 1662, Ellicott City 21043 Or Pay Online: www.HCYP.org NO REFUNDS
Place: Date: Time:
Girls & Boys Age 5 – 14
Centennial High School (4300 Centennial Lane, Ellicott City) March 28 – April 1, 2016 9:00 – 3:30
EACH PLAYER RECIEVES • Team T Shirt • Achievement Award COST: $200.00
PLUS: *Experienced Coaches
Before & After Care Available: Before & After care $50 for the week (Pay onsite or add-to fee for mail-in) Before Care 8-9am After Care 3:30 -5:00pm For Further Information contact: Coach McDuffie : [email protected] or 443-474-4211 HCYP WEBSITE: www.hcyp.org
Name: ________________________________________________________________________________________________________________________ Home Address:_______________________________________________________________________________________________________________ Email:________________________________________________________ _________Phone_________________________________________________ Before Care Y_____ N _____ After Care Y _____ N ______ Both Y______ N _______
* Nut Allergy Y______ N _______
School Name:_________________________________________________________________________Age ________Shirt Size_________________ Parent/ Guardian Name:_____________________________________________________________________________________________________________________ Will camper be taking medication during camp? Yes_______ No____ if yes please explain: I hereby register the above camper/campers as a participant in the basketball program. I certify that I am the parent/ legal guardian of the said camper/campers and hold harmless the HCYP Inc., from any and all liability for any injury, illness or condition that may arise as a result of participation in this program. I also certify that the above camper/campers birth date / age is accurate as indicated. ___________________________________________________________________________________________________ Date:________________________________________ Signature of Parent/Guardian
Mail application/ check payable to: HCYP - Spring Break Basketball Camp 2016 HCYP, Inc. P.O. Box 1662, Ellicott City 21043 Or Pay Online: www.HCYP.org NO REFUNDS
