FUTURE TIGERS YOUTH BASKETBALL CAMP Monday, July 7th - Friday, July 11th, 2014 Excelsior Springs High School Gym FOR MORE INFORMATION contact Head Coach Ryan Johnson at 816.261.4340 or [email protected]

ABOUT THE CAMP

COST

REGISTRATION

The Excelsior Springs Men’s Basketball program annually hosts a week long youth camp geared towards basketball fundamentals and skill development in a fun atmosphere. The camp will run Monday, July 7th - Friday, July 11th from 121:30pm (Grades 1-4) and 1:30-3pm (Grades 5-8) daily. The camp will be held at the Excelsior Springs High School Gym.

Cost for the camp is $40 per camper.

You can Pre-Register by sending the Registration/Waiver Form below (make sure both sides are complete) and payment to:

WHO MAY ATTEND Session 1 from 12:00-1:30pm is for boys entering grades 1-4 for the 2014-2015 school year. Session 2 is for boys entering grades 5-8.

WHAT YOU GET    

Strong development of fundamentals. Instruction from High School coaches and players. Camp t-shirt. Certificate of participation.

Excelsior Springs Men’s Basketball Attention: Ryan Johnson 612 Tiger Drive Excelsior Springs, MO 64024 Make checks payable to: Excelsior Springs Men’s Basketball

CAMP INSTRUCTORS Excelsior Springs Men’s Basketball staff and men’s basketball players will be on hand to work with and evaluate campers.

Registrations will also be accepted from 121:30pm and 1:30-3:00pm on Monday, July 7th at the Excelsior Springs High School Gym.

EXCELSIOR SPRINGS

Tiger Pride!

@ESHSTigerBBall www.facebook.com/esmensbasketball

www.estigerbasketball.com

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Excelsior Springs High School Future Tigers Youth Basketball Camp PLEASE RETURN THIS FORM (COMPLETE BOTH SIDES) ALONG WITH PAYMENT TO: Excelsior Springs High School - Attn: Ryan Johnson - 612 Tiger Drive - Excelsior Springs, MO 64024 Name____________________________________________________________________ Parents/Guardians_________________________________________________________

Session Attending: Session 1 ○ Grades 1-4 (12:00 p.m. - 1:30 p.m. Daily)

Address__________________________________________________________________

Session 2

○ Grades 5-8 (1:30 p.m. - 3:00 p.m. Daily)

City____________________________ State_________________ Zip_________________ T-Shirt Size: E-mail______________________________________ Phone________________________

Youth Sizes

School______________________________ Year/Grade___________________(2014-15)

Adult Sizes

○S ○S

○M ○M

○L ○L

Please make checks payable to: Excelsior Springs Men’s Basketball

○ XL ○ XL

FUTURE TIGERS YOUTH BASKETBALL CAMP Monday, July 7th - Friday, July 11th, 2014

Excelsior Springs High School Gym - Excelsior Springs, MO

CAMP INFORMATION Excelsior Springs High School Future Tigers Youth Basketball Camps are hosted at the Excelsior Springs High School Gym, at 612 Tiger Drive in Excelsior Springs, MO, 64024. For additional information, log on to www.estigersbasketball.com or contact Men’s Basketball Head Coach Ryan Johnson at [email protected] or 816-261-4340. Excelsior Springs High School Men’s Basketball

www.estigerbasketball.com

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EXCELSIOR SPRINGS HIGH SCHOOL FUTURE TIGERS YOUTH BASKETBALL CAMP WAIVER, ASSUMPTION OF RISK AND CONSENT AGREEMENT FOR PARTICIPATION

Camper’s Name: ____________________________________ The undersigned warrants and represents that he/she is a parent or legal guardian of ____________________________ (hereinafter referred to as the “Camper”) and that the undersigned possesses the authority to execute this Waiver of Liability/Release of Claims on behalf of the Camper. The Camper herein described has permission to engage in all camp activities except as noted. I hereby give permission to the camp to provide routine health care, administer prescribed medications, and seek emergency medical treatment including x-rays or routine tests. I agree to the release of any records necessary for insurance purposes. I give permission to the camp to arrange necessary related transportation for me/my child. In the event that I cannot be reached in an emergency, I hereby give permission to the physician selected by the camp to secure and administer treatment, including hospitalization, for the person named above. This completed form may be photocopied for trips out of camp. I/We, the parent(s) of the above stated camper understand and acknowledge that there are inherent risks and dangers in the activities and programs offered by Excelsior Springs High School Future Tigers Youth Basketball Camp. I/We hold Excelsior Springs High School harmless of any accidents/injuries relating to the activities, programs, and transportation services rendered by the school district. I/We release Excelsior Springs High School of all legal responsibility and liability. Signature of Parent/Guardian: _____________________________________________________________________ Printed Name of Parent/Guardian: _________________________________________________________________

Date: ____________________