Lee-Davis High School

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Grade: _____________

Note: Please complete insurance/liability waiver on reverse side.

Parent/Guardian Signature: _________________________________________________

Parent/Guardian: ___________________________________________________________

Phone: (Home): _____________________ Business: ________________________ Other: ______________________

City _____________________________ State ________ Zip ________________

Address ______________________________________________

Camper’s Name: _______________________________________________

3rd-8th Grade Campers—$75.00

Boys and Girls Basketball Camp @ Lee-Davis H.S.

√ Boys and Girls Camp Grades 3rd-8th

√ December 27-29

√ 9:00am-12:00pm (lunch is not provided)

√ Cost: $75.00 Checks made out to Lee-Davis High School

√ Camp T-Shirt (Handed out on Last Day)

√ Camp Location: Lee-Davis H.S.

Lee-Davis High School

Alvin Puller and Chad Bishop L-DHS Basketball 7052 Mechanicsville Pike Mechanicsville, VA 23111 Questions? Call (804) 723-2203 L-DHS Athletics Office

December 27-29, 2017

INFORMATION

School Main Gym & Aux. Gym When to arrive: 8:30am on Dec. 27th to register & check-in for camp By 8:45am on Dec. 28th & 29th to stretch and be ready to go!!

Featuring: Chad Bishop, L-DHS Head Boys’ Coach; Alvin Puller, L-DHS Head Girls’ Coach; L-DHS Assistant Coaches & Players What to bring & wear: Wear shorts & basketball shoes. Bring water bottles and an easy to eat snack!

CAMP ACTIVITIES:

FUNDAMENTALS

CONTESTS

5 on 5 GAMES 

Camp awards will be given on the last day of camp (Dec. 29)



Each camper will receive a FREE camp T-shirt

Lee-Davis H.S. Youth Basketball Camp

Registration forms will also be accepted on the first day of camp.

Mail registration form along with your check (made payable to L-DHS) by December 14th to Lee-Davis High School c/o Basketball Program 7052 Mechanicsville Pike Mechanicsville, VA 23111

Parent/Guardian Signature: _____________________________________________ Date: ________________

I will accept responsibility for all financial liability incurred by ___________________________ (camper’s name) as a result of an accident or injury while he is a participant in the L-DHS Basketball Camp.

Our insurance coverage is with: ______________________________________ Policy # ________________________

The Lee-Davis High School Basketball Camp does not provide medical insurance for campers. Each camper’s parent/guardian must sign the waiver form and state their insurance coverage.

Location: Lee-Davis High

Insurance/Liability Waiver

Grades: 3rd-8th

**Clip and Mail. Keep the rest for your information**

2017 Youth Basketball Camp