Cleveland State Girl’s Basketball Camp 2010

June 14-17

Who:      Girl’s Ages 6-15 who will be instructed by Coach Dan Lumpkin and Coach Randy Evans.

What:     Camp will focus on both fundamental and team concepts.

              Instruction on proper shooting form, ball handling, & defense.

When:    June 14(Monday) – 17 (Thursday) – 9am – 12pm                                                                                                                

(Please arrive by 8:30am in the lobby of L Quentin Lane Gymnasium for registration.)

Where:    Cleveland State Community College

 

What to Bring:  Gym Shorts, T-shirt, Tennis Shoes, money for concession break.

 

Cost:        $55 per camper;  $10 off (Sister rate - $55 for one then $45 each additional sibling.)

 

*Each camper will receive a free T-shirt    *Concessions will be available       *Lunch Provided

 

*To guarantee a spot in camp, please call 423-614-8721 or email dlumpkin@clevelandstatecc.edu and/or send form and make check to:

Dan Lumpkin

PO Box 3570

Cleveland, TN 37320

*For more information call 423-614-8721 

Please Return With Payment

Name ______________________________                                        Grade/Age __ _/_   _

Address (street, city, & zip) ___________________________________________________________

 

Parents Name __________________________________ Phone _(         )             -           _              __

 

School attended ________________________________T-shirt Size _ _YS___YM___YL _  _AS___AM___AL___AXL

Emergency contact:                                                   Number:  (         )             -                    __

 As the parent and legal guardian of                                          , an enrollee in the Cleveland State Basketball Camp described in this brochure, I do hereby acknowledge that the activity involves some degree of risk of physical harm.  A liability insurance package is provided by the camp and is included in the camp tuition fee.  I am aware that one should not enter this activity unless medically able and properly trained.  I further acknowledge that I voluntarily choose to participate in this activity.  I further acknowledge that I understand that Cleveland State is an institution of the sate of Tennessee, and as such, is not liable for personal injury or property damage except that arising from it’s negligence and that damages for such negligence are limited to those paid by the Board of Claims or the Claims Commission for the state of Tennessee.  As the parent, and/or guardian, of the named minor and in consideration of acceptance of this entry in the aforementioned event, I do hereby release, remiss, waive, and forever discharge Cleveland State, together with all of their officers, agents, officials, and employees from all liability, claims, demands, actions, or causes of action whatsoever arising out of, or related to any injury, illness, loss or damage, relating to participating in the aforesaid event.

 

 

Signature of Parent or Guardian: ______________________         Date: ______________________