(Sponsored by Suffern Boys Basketball Booster Club a nonprofit organization) DATES: Monday, June 25, 2012 Friday, June

ne 29, 2012 TIME: Mon Thursday 9:00am 3:00pm and Friday 9:00am 12:00pm WHERE: Suffern High School CAMPERS: Offered to students entering 5th 10th grades in September, 2012 CAMP FEE: $140.00 - Registration must be postmarked no later than June 1, 2012 LATE FEE: Add $10.00 if postmarked after June 1, 2012 (payment $150.00 if after June 1, 2012) OBJECTIVE: To offer an opportunity to focus on the fundamentals of basketball. Campers will be instructed using group methods and team orientation. Games will be played to reinforce drills, lectures and demonstrations. Skill development using instructional stations such as ball handling, shooting, rebounding, defense and other fundamentals will be part of the daily schedule. In addition, free throw, three point shooting and one-on-one contests will be held throughout the course of the week. CAMP POLICIES:
*No refunds will be given to campers who voluntarily leave camp or who are sent home for disciplinary reasons. * Campers must provide their own lunch / drinks/bathing suit and towel for pool * Complete camp application and statement of health below with parent/guardian signature * Campers should dress appropriately: shorts, t-shirt, socks, sneakers
Please make checks payable to: Suffern Boys Basketball Booster Club and remit payment along with signed application to: Jerry Jefferson, 9 St. Joan Place, Sloatsburg, NY 10974

---------------------------------------------------------------2012 BOYS BASKETBALL CAMP APPLICATION

Camper Grade in Sept. 12: __________ Address _____________________________________ City/St __________ Zip _________ Home Phone: _____________________ Alt. Phone: ________________________________ Name of Parent/Guardian_________________________ Day/work phone: _______________ Email addresses: ___________________________ _______________________________ Emergency Contact: _________________________ Phone(s):__________________________
I understand our family will provide insurance coverage if our son is injured while participating in the Boys Basketball Camp and agree to indemnify RCSD, its BOE, employees and agents for any claim as a result of injury. In addition, I hereby state that my son is in good health and may participate in the Boys Basketball Camp.

Please list any health issues or special circumstances: __________________________________________ _________________________________________________________________________________ ______ Print parent/guardian name: ____________________ Parent/guardian signature: ________________________

Date: ________________