Patriot Basketball Camp
Parent/Guardian Signature: _____________________________
Patriot Basketball Camp One Patriot Drive Marion, AR 72364
I authorize the directors of the Patriot Basketball Camp to act for me accordingly in their best judgment in any emergency requiring medical attention. I will be responsible for any and all treatment. I, the undersigned, as parent and guardian, have actual knowledge and appreciation of the particulars of the camp, including those risks involved in the participation in the basketball camp, and hereby voluntarily consent to said minor’s participation and assumes risks arising therefore.
Address Correction Required
Important Note to Parents
Annual
Patriot Basketball Camp July 10th-14th, 2017 For athletes entering the 3rd through 12th grades for the 2017-2018 school year
Patriot Basketball Camp The annual Patriot Basketball Camp will be held at Patriot Arena July 10th-14th. The camp will focus on sharpening skills of the fundamentals of basketball including rebounding, passing, shooting, dribbling, fast break, screening, and trapping. Each camper will receive a camp t-shirt. The camp is open to any athlete who will be entering 3rd through 12th grade this fall. The cost of the camp is $75. Each camper should wear shorts, t-shirt, and tennis shoes. Each camper will also need to bring water. The camp will also have a concession stand for athletes to buy hamburgers, hotdogs, nachos, and drinks at a reasonable price. Campers may also bring a lunch. Please contact Shunda Johnson, Renaldo Clay, or Johnny Washington with any questions.
Camp Staff Coach Shunda Johnson, MHS Head Girls Basketball Coach
Coach Renaldo Clay, MHS Assistant Girls Basketball Coach
TBA, MHS Head Boys Basketball Coach
Coach Monty Patel, MHS Assistant Boys Basketball Coach
Coach Johnny Washington, MJHS Head Boys Basketball Coach
Sign-up Form Grade next school year Sign up for:
Time
Date
Price
3rd Grade Camp
8am-2pm
7-10/7-14
75.00
4th Grade Camp
8am-2pm
7-10/7-14
75.00
5th Grade Camp 6th Grade Camp
8am-2pm
7-10/7-14
75.00
8am-2pm
7-10/7-14
75.00
8am-2pm
7-10/7-14
75.00
7th Grade Camp
8 Grade Camp
8am-2pm
7-10/7-14
75.00
9th-12th Grade
8am-2pm
7-10/7-14
75.00
th
Camper’s Name
Coach Jerome Mitchell, MJHS Assistant Basketball Coach
Parent’s Name
Coach Shellena Stone, MJHS Head Girls Basketball Coach
Daytime Phone
Cell Phone
Method of Payment of Deposit
Cash
Check
Money Order
School: (870) 739-5130
Make Checks/Money Orders Payable to “Marion Athletic Department”
Coaches Contact Information:
T- Shirt Size
Shunda Johnson: (901) 679-9895 Renaldo Clay: (901) 355-9358 Johnny Washington (901) 338-4741
Thanks in Advance from the Marion School District Boys & Girls Basketball Staff’s
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult XX-Large
Registration will followingtimes: times: Registration willbe beheld held at at the the following Saturday, July July 81thfrom from 9-12 9-12 pm Saturday, pm th Monday, July July 10 (beforecamp camp at at 8 8 am) Monday, 3 (before am) Patriot Basketball Patriot Basketball Camp Camp Patriot Arena Patriot Arena Marion, AR 72364 Marion, AR 72364 Phone: (870) 739-5130
Patriot Basketball Camp One Patriot Drive Marion, AR 72364
I authorize the directors of the Patriot Basketball Camp to act for me accordingly in their best judgment in any emergency requiring medical attention. I will be responsible for any and all treatment. I, the undersigned, as parent and guardian, have actual knowledge and appreciation of the particulars of the camp, including those risks involved in the participation in the basketball camp, and hereby voluntarily consent to said minor’s participation and assumes risks arising therefore.
Address Correction Required
Important Note to Parents
Annual
Patriot Basketball Camp July 10th-14th, 2017 For athletes entering the 3rd through 12th grades for the 2017-2018 school year
Patriot Basketball Camp The annual Patriot Basketball Camp will be held at Patriot Arena July 10th-14th. The camp will focus on sharpening skills of the fundamentals of basketball including rebounding, passing, shooting, dribbling, fast break, screening, and trapping. Each camper will receive a camp t-shirt. The camp is open to any athlete who will be entering 3rd through 12th grade this fall. The cost of the camp is $75. Each camper should wear shorts, t-shirt, and tennis shoes. Each camper will also need to bring water. The camp will also have a concession stand for athletes to buy hamburgers, hotdogs, nachos, and drinks at a reasonable price. Campers may also bring a lunch. Please contact Shunda Johnson, Renaldo Clay, or Johnny Washington with any questions.
Camp Staff Coach Shunda Johnson, MHS Head Girls Basketball Coach
Coach Renaldo Clay, MHS Assistant Girls Basketball Coach
TBA, MHS Head Boys Basketball Coach
Coach Monty Patel, MHS Assistant Boys Basketball Coach
Coach Johnny Washington, MJHS Head Boys Basketball Coach
Sign-up Form Grade next school year Sign up for:
Time
Date
Price
3rd Grade Camp
8am-2pm
7-10/7-14
75.00
4th Grade Camp
8am-2pm
7-10/7-14
75.00
5th Grade Camp 6th Grade Camp
8am-2pm
7-10/7-14
75.00
8am-2pm
7-10/7-14
75.00
8am-2pm
7-10/7-14
75.00
7th Grade Camp
8 Grade Camp
8am-2pm
7-10/7-14
75.00
9th-12th Grade
8am-2pm
7-10/7-14
75.00
th
Camper’s Name
Coach Jerome Mitchell, MJHS Assistant Basketball Coach
Parent’s Name
Coach Shellena Stone, MJHS Head Girls Basketball Coach
Daytime Phone
Cell Phone
Method of Payment of Deposit
Cash
Check
Money Order
School: (870) 739-5130
Make Checks/Money Orders Payable to “Marion Athletic Department”
Coaches Contact Information:
T- Shirt Size
Shunda Johnson: (901) 679-9895 Renaldo Clay: (901) 355-9358 Johnny Washington (901) 338-4741
Thanks in Advance from the Marion School District Boys & Girls Basketball Staff’s
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult XX-Large
Registration will followingtimes: times: Registration willbe beheld held at at the the following Saturday, July July 81thfrom from 9-12 9-12 pm Saturday, pm th Monday, July July 10 (beforecamp camp at at 8 8 am) Monday, 3 (before am) Patriot Basketball Patriot Basketball Camp Camp Patriot Arena Patriot Arena Marion, AR 72364 Marion, AR 72364 Phone: (870) 739-5130
