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BASKETBALL WORLD Day Camp Application 2009 |
| Name:
Age at
Camp: |
| Street: |
| City:
State:
Zip: |
| Parent's Name: |
| Phone: Home(
)
Office(
)
|
| E-mail: |
| Height:
Weight: Circle
T-Shirt Size: S M L XL |
| School or Team:
Grade Next
Year: |
| Have you attended our camp(s) before?
Year(s): |
| I learned about camp through: |
| Family Health Insurance Co: |
| Family Health Insurance No: |
I certify that the applicant is
in good health and may participate in physical activities associated with
the camp's vigorous athletic programs, without limitation(s). The director
of the camp has my permission
to arrange for, and provide medical care in the event the applicant is
injured or disabled. I understand that
the camper must present to the camp director, before participation in
camp, a medical certificate from
a physician stating that the camper is physically fit to participate in
camp activities. |
| Signed (parent or guardian):
Date: |
Check week(s) with amount of deposit (non-refundable) or full
payment: |
SUFFIELD ACADEMY
185 North Main Street
(Route 75), Suffield, CT 06078
July 27 - 31, Mon. - Fri., 9am - 4pm
Girls Ages 8 - 18
$100 deposit
$250 full
payment
August 3 - 7, Mon. - Fri., 9am -
4pm Boys Ages 8 - 18
$100 deposit
$250 full
payment |
SHOOT IT BETTER Mini Camps
June 13 - 14, 2009, 1:00 - 4:00pm each day, Coed Ages 10 & Above
August 22 - 23, 2009, 1:00 - 4:00pm each day, Coed Ages 10 & Above
Call the Basketball World office for more information! |
Register by April 15 (postmarked) for FREE BASKETBALL! |
FAMILY RATE: Each additional child only $225! |
TEAM RATES Available! |
Total Enclosed:
Balance:
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Check payable to: BASKETBALL WORLD
Mail to: 955 Russell Ave, Suffield, CT 06078
888-812-5452 860-668-7162
www.basketballworld.com |
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Parent or Camper...
1. Print out this application page with your computer's printer.
2. Fill in the information for all sections.
5. Return the application to Basketball World, 955 Russell Ave,
Suffield, CT 06078. |
860-668-7162
•
888-812-5452 |
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laws. |
http://www.basketballworld.com |
