2011-07-25_OH_ tNBA St Francis Summer Basketball Camp.indd

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                                                                         2011 tNBA/St. Francis Summer Basketball Camp

                                            l           and
                    The National Basketball Academy an the St. Francis of Assisi Parish are proud to offer a five day basketball
                    camp designed to improve the skill le of all youth basketball players. The vast knowledge and experience of
                    our basketball staff will help players on fundamentals, practice habits, and teamwork while implementing them
                    in game-like situations. We invite you to join us for five days of fun. A special guest speaker is scheduled, plus
                    every camp attendee will receive a c camp
                                                         ca t-shirt.

                                                                                                                                             July 25-29, 2011
                                                                                                                                      Grades 3-5: 9:00am - 12:00pm
                                                                                                                                           s      12:
                                                                                                                                      Grades 6-8: 12:30pm - 3:30pm
                                                                                   s.          ill separated                           level henever
                                                        Camps are for boys and girls. Campers will be separa by gender, age, and skill leve whenever possible.

                                                                                                                                                    Location: n:
                                                                                                                                           St. Francis of Assisi Parish
                                                                                                                                                         yfield Road
                                                                                                                                               6850 Mayfield Ro
                                                                                                                                                      ills, H 44040
                                                                                                                                             Gates Mills, OH 4

                                                                                                                                                    $ per camper
                                                                                                                                                Includ a camp t-shirt

            Sibling                                                                                           Sibling
            Discount                                                                                          Discount
             $10 off
              each                                                        2011 SUMMER BASKETBALL CAMP REGISTRATION FORM
                                                                                                               $10 off
             camper to register online / Call 216.378.0932 for more information. camper

                                             tNBA/St. Francis                                                       Please complete this registration form, including parent or guardian signature, and send to:
                                                                                                                    The National Basketball Academy, 27600 Chagrin Blvd, Suite 450, Woodmere, OH 44122                                                                                      *Please note all credit cards will be subject to an
                                                                                                                    Make all checks payable to: The National Basketball Academy                                                                                                                        additional service charge
                                                                                                                                                                                                                                                                                                 of 4% of the total dollar transaction.
                                                                                                                    Camper’s Name
                                                                                                                    Parent or Guardian Name
                                 Summer Basketball Camp                                                             Address
                                               July 25-29, 2011                                                     Home Phone                                                                                                Parent’s Work Phone
                                Grades 3-5: 9:00am - 12:00pm                                                       Parent’s Cell Phone                                                                                       Camper D.O.B. (MM/DD/YY)                                                           Grade
                                                                                                                    E-mail                                                                                                                     T-Shirt Size          YM          YL         S         M          L          XL           XXL
                                Grades 6-8: 12:30pm - 3:30pm                                                                                                                                                                                                                                                (on back
                                                                                                                    Credit Card #                                                                                                    Exp. Date                             3-Digit Security#                  of card)
                                   Camps are for boys and girls.
                                                                                                                                                                                                                                                                                                   Amt. charged
                                                                                                                                                                                                                                                                                                         to card $
           The SIGNER grants permission to The National Basketball Academy, the Cleveland Cavaliers, the NBA (and its designees and agents) to utilize the Signer’s child’s image, likeness, actions and statements in any
           live or recorded audio, video, or photographic display or other transmission, exhibition, publication or reproduction made of, or at, the Event in any medium or context without further authorization or compensation.
                                                                                                                                                                                                                                                                                                                                                    Revised 2011-02-16

           We, the undersigned, do hereby consent to our child’s participation in the Cleveland Cavaliers camp. Our child is in good health and can participate in all ac-        In the event that reasonable attempts to reach parents/guardians at phone numbers listed have been unsuccessful, I hereby give my consent for the
           tivities. Therefore, in consideration for the services to be performed by the National Basketball Academy and the Cleveland Cavaliers, I/we do further release         administration of any treatment deemed necessary by: ________________________________________________________(pre-
           their agents and employees and any others associated with the camps from any and all claim or liability to us or our child for any damages or injuries which           ferred physician and phone) or by another licensed physician or the transfer of child to nearest appropriate hospital or emergency facility. This authorization
           may be sustained by our child in connection with the Cleveland Cavaliers camps.                                                                                        does not cover major surgery unless the medical opinions of two licensed physicians or dentists, concurring in the necessity for surgery, are obtained prior to

                                                                                                                                                                                  performance of surgery.
           Parent or Guardian Signature ___________________________________________________                                                                                       Parent or Guardian Signature _____________________________________________________

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