NEWMAN SMITH

BOYS AND GIRLS BASKETBALL CAMP MON-WED June 4th-6th, 2012 1:00-4:00 P.M.
NEWMAN SMITH HIGH SCHOOL MAIN GYMNASIUM (At back of School) 2335 N. JOSEY LANE, CARROLLTON, TX 75006 COST: $ 50.00 PER CAMPER (IF YOU REGISTER BY JUNE 1st) FOR INCOMING 3rd - 9TH GRADE BOYS AND GIRLS EACH CAMPER WILL RECEIVE A T-SHIRT BASIC FUNDAMENTALS AND TEAM CONCEPTS WILL BE TAUGHT DAILY. CONCESSIONS WILL BE AVAILABLE DAILY AND TROJAN SPIRIT WEAR Please Pre-register to ENSURE CORRECT T-SHIRT SIZE AND SO WE MAY GET A HEAD COUNT & HAVE THE APPROPRIATE NUMBER OF COACHES ON STAFF THAT WEEK. ***WALK UP REGISTRATION WILL BE ACCEPTED ON THE FIRST DAY OF CAMP 12:30 ***There will be a $10.00 late registration fee on the day of**** **CASH, CHECKS, or Money Orders ACCEPTED (DRIVERS LICENSE AND PHONE NUMBER MUST BE ON CHECK) ****MAKE CHECKS TO CFBISD ATHLETICS and RETURN REGISTRATION FORM TO: ATTN. JULIE LOWREY/PERCY JOHNSON -NSHS BASKETBALL CAMP 2335 N. JOSEY LANE, CARROLLTON, TX 75006 ANY QUESTIONS PLEASE CONTACT: CAMP DIRECTORS: HEAD BOYS OR GIRLS BASKETBALL COACH Percy Johnson 972 968-5301 or Julie Lowrey @ 972 968-5306 johnsonpe@cfbisd.edu lowreyj@cfbisd.edu
Cut along dotted line and mail registration form in with check. Save top for your records.

Summer 2011 NSHS Basketball Camp Registration Form

Camper Name: ______________________________________ Address: ____________________________________ City: ______________ Zip: ___________ Age: ____________ Please check either : Male: ___ Female: _____ Next Years Grade: ______ School: _____________________ Parent/Guardian Name: ______________________________ Home Phone: ______________________________________ Email Address: ______________________________________ Parent Cell Phone : __________________________________ Emergency Contact: __________________________________ Emergency Phone: ___________________________________
. Make check out to CFBISD Athletics for $50.00 Check # _____________ Cash Amt._______

YM

Please circle T-shirt Size Below:

XL

XXL

Note* Please fill out and sign and return the Parental Signature Release Form on back page with registration form*

Parental Signature Release Form

Campers Name______________________________ PARENTS: In accordance with the rules of the Trojan Summer Sports Camp, I hereby give my consent for my child to participate in any and all camp activities. If at any time it is necessary for the aforementioned camper to receive services from an off-campus medical or physical facility, the camp will secure transportation as is deemed necessary. I will not hold the camp responsible for any benefits beyond the camp medical insurance programs and will secure adequate family insurance coverage if additional protection is desired. Insurance Company and Policy Number ___________________________ Parent/Guardian Signature: _______________________ Date: ___

Recognition and Assumption of Risk Agreement

I, the undersigned parent/legal guardian of _____________________________, authorize said childs participation in the Trojan Sports Camps. In and for consideration of my childs participation in the Trojan Sports Camps, I hereby agree that I will not hold the Newman Smith staff, the Carrollton School District or its employees responsible for any loss, damages, or personal injuries that he/she may receive as a result of participation. This waiver of liability expressly includes camp activities, or while in, or upon the premises whereby the activity is being conducted. I also agree to follow all instructions and procedures in order to maintain a maximum level of safety, and that I should make sure my child is covered with adequate insurance in the event of a serious accident. I also give my permission for emergency medical care or treatment by a physician, surgeon, hospital, or medical care facility that may be required, and accept the responsibility for the cost. This form must be filled out and returned with the application. Parent/Guardian Signature:_________________________________Date:_______________ Camper Signature:__________________________________Date:____________