Coach Carolyn Wendte's 4th-7th Basketball Camp Sign-up

                                Coach Wendte's 4th-7th Basketball Camp

When: May 13-May 16

Where: Beecher City High School

Times: May 13-May 15: 5:30-7:30 p.m.

May 16: 9-11 a.m. (Saturday morning)
Cost: $35.00

**Note: If playing SIBC Basketball this year—no cost unless you want the t-shirt from camp which is $10

Make Checks payable to: Beecher City High School

Mail to: Beecher City High School

% Carolyn Wendte

P.O. Box 97

Beecher City, IL 62414

Registration Deadline: (to receive the shirt and camp pack) April 29, 2015

If you have any questions feel free to call Coach Wendte at 618-487-5117

(Cut and send in portion below) (Please Print)

Name: ______________________ Grade: _________

Address: ______________________ City: ____________________

Home Phone: _________________ Emergency Phone: _____________

(Please circle one)

Shirt Sizes -- Youth:      Medium        Large

Adult:     Small       Medium       Large       Xlarge       XXLarge

Parent Release:

I hereby authorize the staff of the Beecher City High School Basketball Camp to act for me according to their best judgment in any emergency requiring medical attention, and I hereby waive and release the camp from any and all liability for any injuries or illness incurred while at camp. I have no knowledge of any impairment that would interfere with the camper’s participation in the camp program.

Signature of Parent or Guardian: _________________ Date: _____________