http://memphisgirlsbasketball.com

1. Basketball Skills Camp
Boys and Girls ages 7-16
Learn the fundamentals of basketball
Fun, energetic drills and games
Guaranteed to increase your basketball IQ
LOCATION: Bert Ferguson Community Center
8505 Trinity Rd.
Memphis, TN 38018
CAMP DATES: July 30- August 3
9am-1pm
PRICE: $105 Includes T-shirt
SPACE LIMITED TO 60 CAMPERS
CONTACT: Coach Davitria Harrell
Phone: 817.404.2196
Email: funsound@msn.com
___________________________________________________________________________________________________________________
REGISTRATION: Send money order or cashier's check to Coach Davitria Harrell: 111 S. Highland Ave., P.O. Box 371, Memphis, TN,
38111
Childs Name ______________________________________ Age______
Address __________________________________________ City_____________________ Zip________
Parent(s)/Guardian(s) Name __________________________ Email ____________________________________________
Mother’s Cell ________________ Work ________________
Father’s Cell ________________ Work ________________
Emergency Contact _____________________ Phone ________________
I, the undersigned parent or guardian, understand that myself and/or my child are to act in a sportsmanlike manner at all times, and agree that my child shall abide by the following: use of acceptable
language and social behavior, refrain from use of alcohol, tobacco, or illegal drugs, listen to directions of coaches and show respect towards coaches at all times, attendance of a ll practices and games. I
understand that if my language, behavior or attitude with players, other parents, coaches or officials is negative, I will be subject to being reprimanded and/or possible suspension according to the
FUNdamentally Sound polocies. I will also abide by the NYSCA Parents/Participant Code of Ethics Policy.
I/We do further hereby release, absolve, indemnify and hold harmless the FUNdamentally Sound organization, the organizers, sponsors, service provider, supervisors, all employees thereof, and/or all of the
above, incidental to the conduct of activities and transportation to and from such. In case of injury, I likewise waive all claims against the organizers, sponsors, employees, or any instructors appointed by
them. I/We imply that all information given on this form is true and understand that suspension from FUNdamentally Sound programs is possible if any information is false.
My signature below certifies that I have read and understand the requirements for my child and myself as a parent/guardian, to participate in FUNdamentally Sound activities.
PRINT NAME____________________________________________ SIGNATURE____________________________________________________
FOR STAFF USE ONLY, PLEASE DO NOT WRITE IN BOX
FEE PAID $__________ (CASH/CHECK) DATE PAID ________/ ________/ ________
RECEIPT #________________ STAFF MEMBER TAKEN BY _____________________