Bobcat Basketball Camp

 BOBCAT BASKETBALL CAMP When: June 6th-9th (Mon.-Thurs.)
Where: High School Gym
Sessions: Incoming 2nd-5th graders 9:00-11:30 am
Incoming 6th-9th graders 1:00-3:30
Cost: $40 per child ($20 for each additional immediate family member)
Campers will be working on the fundamentals of shooting, passing, dribbling, and offensive moves.
Please Mail Registration Form (One per child) and check to:
Bobcat Basketball Camp
C/O Brent Gaylor
910 Avenue K NW
Childress, TX 79201
**Make Checks Payable To: Brent Gaylor**
If you have any questions please contact Coach Gaylor @ bgaylor@childressisd.net or 937-2245
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Name: __________________________________ School:_______________________________
Address: ________________________________ City, State, Zip:_________________________
Home Phone: _________________ Work Phone: ______________ Cell Phone: _____________
Parent/Guardian: _____________________________________________________________
(PLEASE PRINT)
As the parent/guardian of _________________________________ I release, waive, discharge Childress High School, its employees, staff, and administration
from any and all liability claims resulting from loss, injuries, illness, and other damage including death which may be sustained by my child during the duration of
the Childress Basketball Camp. To the best of my knowledge, my child is in good physical condition and I am not aware of any physical infirmity which would
place my child at risk while participating in the camp. During the period of the camp, I hereby give permission to the staff of Childress High to administer proper
medical assistance to my child in the event of accident, illness or injury. I understand that I will be responsible for any and all costs of medical treatment and
coverage provided not covered by insurance.
I HAVE READ THE WAIVER OF LIABILITY AND FULLY UNDERSTAND ITS TERMS.
Parent/Guardian Signature: ______________________ Date: _________________
Emergency Contact: ____________________________ Phone: _______________