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 27, 28, & 29, 2008
Tuesday thru Thursday

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

2008 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:

Jeff Paolucci
Athletic Director
Otero Junior College
1802 Colorado Ave.
La Junta, CO 81050

Registration Time Tuesday May 27 at 7:30 a.m. in the Gymnasium.

Cost: $70.00 if mailed by May 22, 2008

Cost: $75.00 after May 22, 2008

Mail fee and registration form by May 22, 2008 to Jeff Paolucci, otherwise bring with you on first day of camp.

Name:

Sex:
          M           F

HT:

WT:

Address:

City:

ST:

ZIP:

School Attending:

Adult Shirt Size:
    YL        S        M        L        XL

Age:

Grade entering in Fall of 2006:

Home Phone:
(        )

Work Phone:
(        )

Parents Name(s):

email:

In Case of Emergency Contact:

Phone:
(        )

Insurance:


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



Parent or Guardian Signature: ________________________________________________________


Make checks payable to Otero Junior College Basketball Camp
Mail by May 22nd ~ C/O Jeff Paolucci, Athletic Director Otero Junior College - 1802 Colorado - La Junta, CO 81050.