LADY MUSTANG SUMMER BASKETBALL CAMP
The goal of the Lady Mustang Summer Basketball Camp is to provide a complete, in-depth basketball experience emphasizing fundamentals in order to allow young players to reach their full potential. The Lady Mustang Summer Basketball Camp is a great place to improve your skills and to compete against good players. We look forward to seeing you at our camp.
Dates: - May 28th toJune 1st, 2012
Camp Location:North High School New Gym
Camp Address:1101 E. Thomas Rd. - Phx, AZ85014 Camp Fee:$40.00 per player (Fee deadline is May11th)
Camp Time:4:00 pm to 6:00 pm
Camp for Girl's:6th – 12th grades
If you are interested in improving your basketball skill level this is the basketball camp you want to attend. The coaching staff has the experience and knowledge to make you a better basketball player. I hope to see you at the camp.
FOR MORE INFORMATION PLEASE CONTACT COACH SHABAZZ (602) 575-3491
6TH ANNUAL LADY MUSTANG GIRL’S SUMMER BASKETBALL CAMP
Cost: $40 per camper
Time: 4:00pm-6:00pm
Location: North High Gym
Dates
May 28th – June 1st
For 6th – 12th grade girls
NAME ______
SCHOOL______AGE______GRADE______
HOME ADDRESS______
CITY______STATE______ZIP CODE______
HM PHONE NUMBER______CELL/OTHER #______
PARENT/GUARDIAN______
CAMPFEE:$40 ______CASH______CHECK
***PLEASE MAKE ALL CHECKS PAYABLE TO: COACH DARIYON SHABAZZ, and mail to: 6613 S. 18th Dr. , Phoenix, AZ 85041
T-SHIRT: CIRCLE SIZE: ADULT SIZESSMLXLXXL
MEDICAL RELEASE FORM:
NAME OF CAMPER
PARENT OR GUARDIAN SIGNATURE
PAST HEALTH PROBLEMS
PAST/PRESENT INJURIES
PRESENT HEALTH PROBLEMS
CURRENT MEDICATIONS
DRUG SENSITIVITIES
OTHER ALLERGIES
CAMPERS HEALTH INSURANCE CARRIER
POLICY #
INSURANCE COMPANY ADDRESS
HEALTH INSURANCE PHONE #
OTHER NECESSARY INFO
I VARIFY THAT MY CHILD HAS BEEN CHECKED BY A LICENSED PHYSICIAN AND IS PHYSICALLY ABLE TO PARTICIPATE IN THE LADY MUSTANGS SUMMER BASKETBALL CAMP. I HEREBY AUTHORIZE THE DIRECTORS OF THE LADY MUSTANGS SUMMER BASKETBALL CAMP TO ACT ACCORDINGLY FOR ME TO THEIR BEST JUDGEMENT IN ANY EMERGENCY REQUIRING MEDICAL ATTENTION AND I HEREBY WAIVE AND RELEASE THE LADY MUSTANGS GIRLS BASKETBALL CAMP AND NORTH HIGH SCHOOL FROM ANY AND ALL LIABILITY FROM ANY INJURIES WHILE AT THE CAMP.
PARENT SIGNATURE
IN CASE OF AN EMERGENCY IF PARENT OR GUARDIAN CANNOT BE REACHED PLEASE CALL
PHONE#
LADY MUSTANGS SUMMER BASKETBALL CAMPNorthHigh School
Coach Dariyon Shabazz1101 E. Thomas Rd.
Head Coach, Lady Mustang BasketballPhx, AZ 85014