Health Information

Hospitalization Insurance Company: ______

Policy #:______

Parent/Guardian Signature: ______

Medical Examination Form

I, ______(physicians name) have examined, ______and found him/her to be free of any communicable diseases and physically able to participate in any and all camp activities.

Physical Limitations: ______

Physical Impairments: ______

Allergies, Others, Comments, Etc.:______

Physicians Signature: ______

If my child needs emergency medical treatment, consent is hereby granted for such emergency treatment as deemed necessary by the staff of Woodford County High school and/or medical personnel. I hereby waive and release Woodford County High School and all camp staff from any liability for injuries incurred while participating in the camp.

Parent/Guardian Name: ______

Signature: ______

Date: ______

Emergency Contact: ____________

* Every Camper must have insurance and a physical before participating. If your son or daughter played on a school team, a copy of that physical will be acceptable. The physical has to be within the last calendar year. Insurance and physical forms are A MUST before any camper can participate.

June 10-13

Grades K-5 8:00-11:30

Grades 5-8 12:30-4:00

Coach Scott Hundley

Coach Hundley will be in his fourth season as head coach for the Woodford County Yellow Jackets next season. In his three seasons as head coach he has lead the team to 2 district championships, 3 regional appearances, and the regional finals. He has posted an overall record of 58 wins and 37 losses in his three seasons.

As a player Coach Hundley played college ball at Vanderbilt University where he was on full scholarship and a captain on the 2004 sweet sixteen team. He also earned 6th man of the year honors his senior year for the South Eastern Conference. In 2000, Coach Hundley received Mr. Basketball honors for the state of Kentucky.

Coach Hundley has an undergraduate degree in communications from Vanderbilt University and his Master’s degree in Special Education from Georgetown College. He is also happily married to his wife, Torie.

Cost: $75 (Includes t-shirt)

Registration: 7:30-8am & 12-12:30pm

Where: WCHS gymnasium

Who: Boys and Girls, K-8

Drop off: Doors will open 30 min prior

Pick up: 11:30am and 4pm

Awards Ceremony: Thursday at 11am and 3:30pm we will have a ceremony for the campers.

What to Bring: All campers need to BRING A BASKETBALL with them to camp. Please write your name on the ball in permanent marker so that you can find it at the end of camp each day.

Pre-Registration DISCOUNT and Procedures: Mail in your registration along with your check, liability waiver, physical, and copy of insurance card to:

Scott Hundley

160 Seahawk Trail

Midway, Ky 40347

$10 Discount to those who pre-register!!!!!

*Make all checks payable to:

Scott Hundley

This camp is designed to provide young athletes the opportunity to work on drills that will help them improve their shooting, dribbling, passing, defense, and rebounding. The drills are given in hopes that campers will take them home and work all summer long to become better basketball playes.

Campers will also have the opportunity to participate in various games and competitions where their skills are put to the test. The atmosphere of camp will be positive and fun. We will teach good sportsmanship in everything we do during the week.

Camper’s Name: ______

Grade: ______

Age: ______
Address: ______

Contact Phone: ( )

Contact Phone: ( )

T-Shirt Size: Please Circle One

YS YM YL S M L XL XXL

School Attended Last Year: ______