june 16-18 (Thurs., fri., sat.)
2016
LADY TOPPER BASKETBALL TEAM CAMP
june 16-18 (Thurs., fri., sat.) CAMP FEATURES
PAYMENT INFORMATION
6 Games per team (JV and Varsity) KHSAA Officials Training Camp Games in E.A. Diddle Arena T-Shirt For Campers and Coach Camp Store for Refreshments and Lady Topper Gear All games open to family and spectators Competition from Kentucky and neighboring states Coaches Luncheon on Friday, June 17
CONTACT INFORMATION Ervin Williams, Camp Director WKU Lady Topper Basketball 1605 Avenue of Champions Bowling Green, KY 42101 Office: (270) 745-6831
@ $175 PER PLAYER (includes meals, dorm room and t-shirt) @ $625 PER TEAM (commuter status, t-shirt included) Submit a $300 deposit for your school by May 15 to guarantee your spot in the team camp and receive a free gift!
NOTES Complete application and return to basketball office Camp fees must be paid in full prior to participation, per NCAA rules Make checks payable to: WKU Lady Topper Basketball Camp Each player needs to fill out the form included, feel free to make copies for your team Each overnight team is allowed two coaches to attend free per one varsity team. One additional coach per each added team (varsity, JV or freshman). Any extra individuals for overnight teams (assistants, managers) will be charged half price of regular player fee.
School Name
____________________________________________________________________________
Coach Name
____________________________________________________________________________
School Address
____________________________________________________________________________
City
________________________ State
_____________________________
Zip Code _____________
Level (s) Varsity ________________ JV ________________ Freshman ________________ Total Teams ________________ Main Contact ____________________________________________________________________________ Contact Phone
____________________________________________________________________________
Email Address
____________________________________________________________________________ Please fax application to (270) 745-6071 or via email to [email protected]
2016
LADY TOPPER BASKETBALL TEAM CAMP
june 16-18 (Thurs., fri., sat.) PLAYER APPLICATION Camper Name
____________________________________________________________________________
Camper Address
____________________________________________________________________________
City
________________________ State
_____________________________
Zip Code _____________
School Name
____________________________________________________________________________
Coach Name
____________________________________________________________________________
Parent/Guardian ____________________________________________________________________________ Home Phone
____________________________________________________________________________
Cell Phone
____________________________________________________________________________
Email Address
____________________________________________________________________________
T-Shirt Size (circle one)
Youth M
Youth L
Youth XL
Adult S Adult M Adult L Adult XL Insurance Company ____________________________________________________________________________ Policy Number
____________________________________________________________________________
Emergency Contact ____________________________________________________________________________ Relationship to
____________________________________________________________________________
Contact Number
____________________________________________________________________________ Please fax application to (270) 745-6071 or via email to [email protected]
NEGATIVE COVENANT, HOLD HARMLESS AGREEMENT AND MEDICAL RELEASE:
I understand that the Girls Basketball Camps at Western Kentucky University are not functions of Western Kentucky University, and that Western Kentucky University is not responsible for camp activities. I understand that a risk of injury is possible while participating in any sporting activity. In consideration for acceptance of my child/ward as a camper and for the use of University facilities, I, for myself and for my child, do hereby agree that I shall be responsible for all costs associated with any injury or loss that may be sustained by my child as a result of the use of the facilities as Western Kentucky University. In addition, I hereby indemnify and hold harmless Western Kentucky University, the Commonwealth of Kentucky, Girl’s Basketball camps at Western Kentucky University and their agents and employees, from and against any and all claims by any third parties arising out of my child attendance at Girl’s Basketball Camps at Western Kentucky University.
Parents Signature: ___________________________________________________________________________________ (Applicant will not be able to participate unless signed) Lady Topper Basketball Camps are open to all entrants limited only by the age requirements for the specified camp.
LADY TOPPER BASKETBALL TEAM CAMP
june 16-18 (Thurs., fri., sat.) CAMP FEATURES
PAYMENT INFORMATION
6 Games per team (JV and Varsity) KHSAA Officials Training Camp Games in E.A. Diddle Arena T-Shirt For Campers and Coach Camp Store for Refreshments and Lady Topper Gear All games open to family and spectators Competition from Kentucky and neighboring states Coaches Luncheon on Friday, June 17
CONTACT INFORMATION Ervin Williams, Camp Director WKU Lady Topper Basketball 1605 Avenue of Champions Bowling Green, KY 42101 Office: (270) 745-6831
@ $175 PER PLAYER (includes meals, dorm room and t-shirt) @ $625 PER TEAM (commuter status, t-shirt included) Submit a $300 deposit for your school by May 15 to guarantee your spot in the team camp and receive a free gift!
NOTES Complete application and return to basketball office Camp fees must be paid in full prior to participation, per NCAA rules Make checks payable to: WKU Lady Topper Basketball Camp Each player needs to fill out the form included, feel free to make copies for your team Each overnight team is allowed two coaches to attend free per one varsity team. One additional coach per each added team (varsity, JV or freshman). Any extra individuals for overnight teams (assistants, managers) will be charged half price of regular player fee.
School Name
____________________________________________________________________________
Coach Name
____________________________________________________________________________
School Address
____________________________________________________________________________
City
________________________ State
_____________________________
Zip Code _____________
Level (s) Varsity ________________ JV ________________ Freshman ________________ Total Teams ________________ Main Contact ____________________________________________________________________________ Contact Phone
____________________________________________________________________________
Email Address
____________________________________________________________________________ Please fax application to (270) 745-6071 or via email to [email protected]
2016
LADY TOPPER BASKETBALL TEAM CAMP
june 16-18 (Thurs., fri., sat.) PLAYER APPLICATION Camper Name
____________________________________________________________________________
Camper Address
____________________________________________________________________________
City
________________________ State
_____________________________
Zip Code _____________
School Name
____________________________________________________________________________
Coach Name
____________________________________________________________________________
Parent/Guardian ____________________________________________________________________________ Home Phone
____________________________________________________________________________
Cell Phone
____________________________________________________________________________
Email Address
____________________________________________________________________________
T-Shirt Size (circle one)
Youth M
Youth L
Youth XL
Adult S Adult M Adult L Adult XL Insurance Company ____________________________________________________________________________ Policy Number
____________________________________________________________________________
Emergency Contact ____________________________________________________________________________ Relationship to
____________________________________________________________________________
Contact Number
____________________________________________________________________________ Please fax application to (270) 745-6071 or via email to [email protected]
NEGATIVE COVENANT, HOLD HARMLESS AGREEMENT AND MEDICAL RELEASE:
I understand that the Girls Basketball Camps at Western Kentucky University are not functions of Western Kentucky University, and that Western Kentucky University is not responsible for camp activities. I understand that a risk of injury is possible while participating in any sporting activity. In consideration for acceptance of my child/ward as a camper and for the use of University facilities, I, for myself and for my child, do hereby agree that I shall be responsible for all costs associated with any injury or loss that may be sustained by my child as a result of the use of the facilities as Western Kentucky University. In addition, I hereby indemnify and hold harmless Western Kentucky University, the Commonwealth of Kentucky, Girl’s Basketball camps at Western Kentucky University and their agents and employees, from and against any and all claims by any third parties arising out of my child attendance at Girl’s Basketball Camps at Western Kentucky University.
Parents Signature: ___________________________________________________________________________________ (Applicant will not be able to participate unless signed) Lady Topper Basketball Camps are open to all entrants limited only by the age requirements for the specified camp.
