Team Camp Application and Release

Print out this Application and Release Form using our handy button below. Fill in your name, sex, height, weight, mailing address, your daytime and home phone number, school attending and grade, and emergency information in the provided space. Indicate shirt size. Please print legibly! Be sure that a parent or guardian signs the release. Make checks payable to Otero Junior College Basketball Camp.
  

Click Button to Print Order Form Below:

   

  
Boys and Girls Basketball Shootout

Otero Junior College
McDivitt Center Gymnasium
May 31, June 1, & 2, 2011
Tuesday thru Thursday

Boys & Girls Ages 5 ~ 16
Entering Grades K ~ 10th

2011 OJC Basketball Camp Application and Release Form

INSTRUCTIONS: Fill in your name, sex, height, weight, mailing address, your daytime and home phone number, school attending and grade, and emergency information in the provided space. Indicate shirt size. Please print legibly!  Be sure that a parent or guardian signs the release. Make checks payable to Otero Junior College Basketball Camp. Mail Application & Check to:

Gary Addington
Camp Director
Otero Junior College
1802 Colorado Ave.
La Junta, CO 81050

Registration Time Tuesday May 31st at 7:30 a.m. in the Gymnasium at Otero Junior College.

Cost: $70.00 if mailed by May 26, 2011

Cost: $75.00 after May 26, 2011

Mail fee and registration form by May 26, 2011 to Gary Addington, otherwise bring with you on first day of camp.

Name:

Sex:          M           F

HT:

WT:

Address:

City:

ST:

ZIP:

School Attending:

Adult Shirt Size:
    YM        YL        S        M        L        XL

Age:

Grade entering in Fall of 2011:

Home Phone:(        )

Work Phone:(        )

Parents Name(s):

email:

In Case of Emergency Contact:

Phone:(        )

Insurance:


I hereby authorize the OJC Basketball Camp Director/Coordinator to act for me according to his/her best judgement in any emergency requiring medical attention and I hereby waive and release the camp from any and all liability for any injuries and illness incurred while at camp.



Parent or Guardian Signature: ________________________________________________________


Make checks payable to Otero Junior College Basketball Camp
Mail by May 26th ~ C/O Gary Addington, Camp Director Otero Junior College - 1802 Colorado - La Junta, CO 81050.