GIRLS 2010 VIKING BASKETBALL CAMP REGISTRATION FORM
Please TYPE in responses, PRINT form, and remember to SIGN form.
LAST NAME FIRST NAME NICKNAME
ADDRESS CITY STATE ZIP
DATE OF BIRTH GRADE & SCHOOL FALL 2008
HOME PHONE EMERGENCY PHONE
EMAIL
CAMP SESSIONS ***ADVANCED SKILLS FOR GRADES 7-9 ONLY***
GIRLS:
Session I July 19th-July23th 8:30AM-12:00PM
Advanced Skills Clinic July 19th-July23th 1:00-3:00PM

T-SHIRT SIZE YM YL AS AM AL AXL
PAYMENT: Tuition for camp is $140.00; tuition for Advanced Skills Clinic is $110.
Discounts may not be applied toward Advanced Skills Sessions.

Early Enrollment Discount - Registration form mailed before May 1, 2009 Tuition $125
PLEASE VISIT OUR WEBSITE FOR SPECIAL ONLINE DISCOUNTS!

PARENT AGREEMENT
I certify that the named participant is in good health and physically able to participate in this camp. I understand the risk involved with such participation. My child is currently covered by medical insurance. I will in no way hold the Camp, the director, the staff, or the Viking Backers responsible for any injuries resulting to my child while participating in the Viking Basketball Camp.
Name of Participant
Signature of Parent/Legal Guardian DATE
Parent/Guardian's Printed Name
Make check payable to VIKING BASKETBALL CAMP and MAIL check and form to:

GIRLS FORMS: Viking Basketball Camp
c/o Anthony Bell
6678 Possum Ct
Columbia, MD 21045	More Info: Anthony_Bell@hcpss.org or redbell71@yahoo.com