SUMMER CAMPS & SPRING BREAK
SUMMER CAMPS & SPRING BREAK CMS Disclaimer: The information in this flyer is neither endorsed by nor necessarily reflective of the views of the Board of Education, the District or any CMS school.
Summer Camp/Spring Break REGISTRATION FORM
One camper per registration form Camp Hours 9 a.m. – 4 p.m. Extended Care Hours: 7:40 AM drop off & 6:00 PM pick up NAME:_____________________________________________________________ MARK (X) YOUR OPTION OF PAYMENT: Student Attending:
DOB: ______________________
q SPRING BREAK q SUMMER CAMP
q $150 HFFA Members q $175 HFFA Members (with extended care) q $160 Non-Members q $185 Non- Members (with extended care)
ADDRESS: ______________________________________________________________________________________ CITY:_________________________________STATE:__________________________ZIP:_______________________ SCHOOL:____________________________________________________GRADE:_________ EMAIL:_______________________________________________________________________ MOTHER’S NAME:____________________________________________________ PHONE: _____________________ FATHER’S NAME: ____________________________________________________ PHONE: _____________________ In case of an emergency, notify the following person if the parents cannot be contacted. NAME:_________________________________________________________________________________________ RELATIONSHIP:
q Mother
q Father
q Guardian
PHONE: ________________________
I _______________________________ (Please Print Name) authorize my son or daughter to participate in the Back2Basix basketball Summer Camp or Spring Break with Back2Basix for:
q Week 1: Mar 28-Apr 1 q Week 2: June 20-24 q Week 3: July 11-15 q Week 4: July 25-29 q Week 5: Aug. 8-12 I understand that the registration fees do not cover any experience related to AAU Basketball tournaments, state tournaments or any travel expenses for lodging and meals. My q son or q daughter has no medical problems that prohibit him or her from participating in Back2Basix Basketball Camp or Spring Break; therefore I release Back2Basix from any liabilities. I _______________________________(Please Print Name) understand my son or daughter will be held accountable to the rules, regulations and the code of conduct required by Back2Basix. Any violations of these rules may result in suspension from Back2Basix Summer Basketball Camp without refund.
BACK2BASIX SUMMER BASKETBALL CAMP • 704.999.3781 • www.ba2ba.org
SUMMER CAMPS & SPRING BREAK
Registration Begins March 1 Spring Break & Summer Camp! Don’t Wait! Space Is Limited!
• Who:
Student Athletes Ages 5-14
• When: Spring Break: Dates, March 28-Apr.1 Summer Camp: June 20-24, July 11-15, July 25-29, Aug.8-12 • Where: Huntersville Family Fitness & Aquatics 11725 Verhoeff Drive Huntersville, NC 28078 704.766.2222 • Time:
9:00 am - 4:00 am *Early drop off 7:40 am • Late pickup 4:00 pm - 6:00 pm (See fee below)
Register at the HFFA middle desk or mail payment and registration form to: Back2Basix • P.O. Box 853 Huntersville, NC 28078 Registration Fee: • $150 HFFA Member -Per Student Athlete ($160 Non-Member) • With Extended Care *(See times above) $175 HFFA Members ($185 Non-Member) • Students Athletes Must Bring Their Own Lunch • Maximum of 30 Campers per week!
For more information please contact: Coach Thomas Turner 704-999-3781 www.ba2ba.org • [email protected]
Summer Camp/Spring Break REGISTRATION FORM
One camper per registration form Camp Hours 9 a.m. – 4 p.m. Extended Care Hours: 7:40 AM drop off & 6:00 PM pick up NAME:_____________________________________________________________ MARK (X) YOUR OPTION OF PAYMENT: Student Attending:
DOB: ______________________
q SPRING BREAK q SUMMER CAMP
q $150 HFFA Members q $175 HFFA Members (with extended care) q $160 Non-Members q $185 Non- Members (with extended care)
ADDRESS: ______________________________________________________________________________________ CITY:_________________________________STATE:__________________________ZIP:_______________________ SCHOOL:____________________________________________________GRADE:_________ EMAIL:_______________________________________________________________________ MOTHER’S NAME:____________________________________________________ PHONE: _____________________ FATHER’S NAME: ____________________________________________________ PHONE: _____________________ In case of an emergency, notify the following person if the parents cannot be contacted. NAME:_________________________________________________________________________________________ RELATIONSHIP:
q Mother
q Father
q Guardian
PHONE: ________________________
I _______________________________ (Please Print Name) authorize my son or daughter to participate in the Back2Basix basketball Summer Camp or Spring Break with Back2Basix for:
q Week 1: Mar 28-Apr 1 q Week 2: June 20-24 q Week 3: July 11-15 q Week 4: July 25-29 q Week 5: Aug. 8-12 I understand that the registration fees do not cover any experience related to AAU Basketball tournaments, state tournaments or any travel expenses for lodging and meals. My q son or q daughter has no medical problems that prohibit him or her from participating in Back2Basix Basketball Camp or Spring Break; therefore I release Back2Basix from any liabilities. I _______________________________(Please Print Name) understand my son or daughter will be held accountable to the rules, regulations and the code of conduct required by Back2Basix. Any violations of these rules may result in suspension from Back2Basix Summer Basketball Camp without refund.
BACK2BASIX SUMMER BASKETBALL CAMP • 704.999.3781 • www.ba2ba.org
SUMMER CAMPS & SPRING BREAK
Registration Begins March 1 Spring Break & Summer Camp! Don’t Wait! Space Is Limited!
• Who:
Student Athletes Ages 5-14
• When: Spring Break: Dates, March 28-Apr.1 Summer Camp: June 20-24, July 11-15, July 25-29, Aug.8-12 • Where: Huntersville Family Fitness & Aquatics 11725 Verhoeff Drive Huntersville, NC 28078 704.766.2222 • Time:
9:00 am - 4:00 am *Early drop off 7:40 am • Late pickup 4:00 pm - 6:00 pm (See fee below)
Register at the HFFA middle desk or mail payment and registration form to: Back2Basix • P.O. Box 853 Huntersville, NC 28078 Registration Fee: • $150 HFFA Member -Per Student Athlete ($160 Non-Member) • With Extended Care *(See times above) $175 HFFA Members ($185 Non-Member) • Students Athletes Must Bring Their Own Lunch • Maximum of 30 Campers per week!
For more information please contact: Coach Thomas Turner 704-999-3781 www.ba2ba.org • [email protected]
