BAINBRIDGE

BASKETBALL

CAMP

COACHED BY: Penny Gienger, Nicole Hebner, Korrie and Kelly Beemer

With the Spartan Basketball Team

DATE: July 16^th –20^th, 2007

TIME: 9:00 to 1:00 Grades: 4^th –6^th Girls

9:00 to 3:00 Grades: 7^th – 9^th Girls

^{Friday: 9:00 to 12:00 everyone}

PLACE: High School Gym

COST: $150.00 payable to: Northern Peninsula Basketball

Mail to: 10103 Madison Ave. NE, BI, WA 98110

NEED: Lunch

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REGISTRATION FORM: July 16th – 20th

NAME: ________________ _______________GRADE: _________

ADDRESS: _____ _______________________________________ _

PARENT NAME: _____________ ____PHONE #: _____________

EMERGENCY CONTACT NAME: _______________________________

PHONE #: _______________________________

Medical Release

I hereby authorize my child's participation in the Bainbridge Basketball Camp. I know of no mental or physical problems which may effect my child's ability to safely participate. The camp staff is authorized to attend to any health problem or injury my daughter may incur while attending camp. I understand that my daughter must have current and active medical insurance before she may attend camp. Neither I nor my daughter will hold Bainbridge Basketball Camp liable for injuries or expenses relating to injuries while my daughter is at camp.

PARENT/GUARDIAN SIGNATURE: _______________________DATE: ________