All Star Basketball Camp

							                                                     Entry Form
Full name                                                     Address
Date of birth
Age                                                                                   Post code
Home phone                                                    Mobile
Email                                                         School/club
Parent/guardian name                                             Emerg contact no:
Medical conditions


Parental Consent (please sign)                                                           Date
Please Circle Event: ALL STAR II (20/10/07) at Kings Academy, Middlesbrough ALL STAR III
(24/11/07) at Bydales, Redcar. If attending both, circle both.
Although every effort is made to ensure the safety and enjoyment of the participants throughout the event, we cannot accept
liability for damage or loss to property or person.
During the event there will be photograph and video footage, which may appear in the local media and on the
www.game-time.co.uk site This signature acts as permission for participant to be photographed and appear in local media.
In the event of injury Coaches will act on behalf of the parent/guardian in securing medical assistance
If you have any concerns please contact us.
Cost
Camp cost is £15 which must be paid 2 weeks prior to event to claim free camp tee shirt.

Refunds requested 7 days before camp will be made minus £5 admin fee.

Tee Shirt Size (please circle)               XS      S    M      L     XL     XXL
(Adult sizes)

Your primary contact is: James Thomson 07795431869
Please return application and payment asap to:

All Star Basketball Camp
c/o Game Time
10 Rousham Gardens
Middlesbrough
TS5 4GJ
                                                                            Cheques made payable to Game Time