CAMP INSTRUCTOR: SKIP TOWNSEND & STAFF

WHO CAN ATTEND: ALL GIRLS ENTERING 1^ST THRU 9^TH GRADE

SESSION 1: 1^ST-5^TH GRADE 9:00-12:00 AM

SESSION 2: 6^TH-9^TH GRADE 1:00-4:00 PM

SITE: BROCK HIGH SCHOOL GYM

COST: $60.00 (MAKE CHECKS PAYABLE TO SKIP TOWNSEND)

CAMP INCLUDES:

· CAMP T-SHIRT

· CAMP BASKETBALL

· INDIVIDUAL INSTRUCTION

· DAILY DRILLS

· TEAM PLAY

· TOURNAMENTS / CONTESTS / AWARDS

REGISTRATION: ENDS JUNE 9TH

MAIL FORMS TO: SKIP TOWNSEND

909 GRINDSTONE ROAD

BROCK, TX 76087

FOR MORE INFORMATION: CALL 817-694-7167 or 817-594-3492

NAME _______________________________ADDRESS _____________________

PHONE ____________________AGE_________GRADE NEXT YEAR ________

T-SHIRT SIZE : ADULT S M L YOUTH S M L

I HEREBY GIVE MY PERMISSION FOR MY CHILD TO PARTICIPATE IN THE BROCK BASKETBALL CAMP. THIS AUTHORIZATION SHALL WAIVE, RELEASE AND ABSOLVE BROCK ISD AND THE CAMP STAFF FROM ANY LIABILITY FOR INJURY OR ILLNESS INCURRED AT CAMP. I GIVE THE STAFF PERMISSION TO ACT FOR ME ACCORDINGLY TO ITS BEST JUDGMENT IN CASE OF AN EMERGENCY.

PARENT / GUARDIAN SIGNATURE DATE