INDIVIDUAL CAMP APPLICATION. Camper's Name: Parent/Guardian's Name: Parent/Guardians Work Phone: Parent/Guardian's E-Mai
JUNE 25-28
9:00 AM - 5:00 PM A-State HPESS Building Grades K-12
RED WOLVES BASKETBALL CAMP Cost: $190 ($175 for A-State Faculty and Staff) CAMP HIGHLIGHTS • Individual instruction from the Red Wolves coaching staff and players • 3-on-3 competition • 5-on-5 competition • Bump competition • Hot Shot competition • Free Throw competition • Camp T-shirt • Lunch provided each day • Awards Ceremony
AT A GLANCE
When: June 25-28 9:00 AM - 5:00 PM (9-12:00 June 28) Registration Monday, June 25 Where: Health, Physical Education and Social Sciences Building (HPESS) Ages: Grades K-12 Cost: $190 ($175 A-State Faculty/Staff)
CAMP INFORMATION
Medical: A certified athletic trainer is on duty at all times. Every effort is made to ensure each camper’s safety through the training on staff, constant inspection of equipment and careful instruction of campers. Meals: Lunch will be provided for campers taking part in this camp. T-Shirts: Given to all participants. Camp Staff: Members of the A-State men’s basketball team and coaching staff will work with campers, along with other coaches from around the area. Payment: Acceptable forms of payment include cash, checks or money order. Checks should be made to Balado Enterprises, LLC. Full payment is due at registration. Arkansas State University boosters may not pay a camp fee unless the applicant is a family member. In compliance with Ark. Code Ann. Sec. 6-62-401, participants in Red Wolves Basketball Camps understand they are contracting with Coach Balado and the Red Wolves Basketball Camps for this activity,and not with Arkansas State University. Arkansas State University and the State of Arkansas do not assume any contractual obligations for the conduct of Coach Balado or individuals associated with Red Wolves Basketball Camps during this activity.
INDIVIDUAL CAMP APPLICATION Camper’s Name: Parent/Guardian’s Name: Parent/Guardians Work Phone: Parent/Guardian’s E-Mail: Home Address: City, State, Zip: Emergency Contact: Phone: School: Coach: Grade Next Fall: Age: Height: Weight: T-Shirt Size: S M L XL XXL Insurance Carrier: Is camper insured for this camp: Yes No Parent’s Consent: I hereby authorize the staff of “Red Wolves Basketball Camp” to act according to their best judgement in any emergency requiring medical treatment, and I state that the above applicant has been checked and is in sound physical condition to participate in basketball camp. Physician or Parent/Guardian Signature: Date: FOR MORE INFORMATION, PLEASE CONTACT Frank Holloway AT 870-972-2077 or
[email protected] Detach this portion and return with non-refundable deposit ($100) to: Red Wolves Basketball Camp P.O. Box 1000 State University, AR 72467 **Per NCAA rules, all Arkansas State University Men’s Basketball camps are open to any and all entrants and are only limited by number, age, grade level and/or gender**
