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Basketball Camp HCMS - henry.k12.ga.us - henry county high school paris

Basketball Camp HCMS - henry.k12.ga.us-henry county high school paris

Medical Form:
Campers Name "Where Students are
Emergency Contact: Priority 1!"
Name of Contact/Relationship
Phone Number Henr y County
Insurance Information Middle School
_________________________________________ Summer
_________________________________________ Basketball Camp
Campers Social Security Number
Group Number
Medical Information
Physicians Name
Phone Number
Medical History (Allergies)
Consent to treat and release County
I hereby give permission to Henry County Middle Schools'
Camp Supervisors, its employees, trainers or staff members to
take whatever action is necessary for the health and welfare of
my child including consenting on my behalf of any and all Make checks payable to:
Make checks payable to:
medical treatment, procedures, operations and/or hospitaliza- Henry County Parks and Recreation Department Henry County Parks and
tions and I further agree to hold them harmless and indemnify
them for all medical bills incurred for the treatment of my Mail or bring Registration and Medical Forms to: Recreation Department
HCMS Summer Basketball Camp
child. I understand that basketball is a physical sport which can Attn: Tac Cunningham
166 Holly Smith Drive
result in serious injury. I hold Henry County Middle School, its McDonough, GA 30253
employees, trainers or staff members harmless and hereby re-
lease them from liability for any injury to my son/daughter
attending the camp. Sponsored by:
___________________________________________________ TAC CUNNINGHAM 770-898-1638
Signature of Parent or Legal Guardian Phone: 770 957-3945 CLINT SATTERFIELD 678-414-6352
Fax: 770 898-4986
E-mail: tcunningham@henry.k12.ga.us
? 2005 Henry County Middle School Athletic Department
by Earlene E. Harrison
Registration Form
Daily Camp Schedule ____________________________________________________
Camp Information 8:30 Arrival--Shoot around
Camper's Name
CAMP COST--$100.00 per 9:00 Roll Call--Morning Lecture
Street Address
child (Discounts will be given 9:15 Stretch ____________________________________________________
to families with more than 9:25 Morning Station Work
City State Zip code
one child attending) ? Lay Ups ____________________________________________________
Parent (s) or Legal Guardians Name
? Ball Handling
? Dribbling
Parent (s) or Legal Guardians Name
? Shooting
? Passing Parent (s) or Legal Guardians Address
? Free Throws ____________________________________________________
10:30 Morning Break Parent (s) or Legal Guardians Phone Number
10:45 Contests ____________________________________________________
? Campers will be trained by a ? Free Throws Parent (s) email address (If applicable)
top-notch staff of seasoned ? Gotcha ____________________________________________________
coaches and players. ? Hot Shot Name of School Camper Currently Attends
? Lay Ups
? Campers will have the opportu- 11:30 Lunch--Free Shoot T-Shirt Size
nity to participate in daily con- 12:30 Roll Call Youth Small
tests designed to assist them in 12:40 Afternoon Station Work Youth Medium
improving their skills ? Defensive Stance and Slides
Adult Small
Adult Medium
? Rebounding and Box out
Adult Large
? Campers will participate in vari- ? Closeout and 1 on 1 Adult X-Large
ous competitions to include ? Defending and Pick and Roll Adult XX-Large
various offense and defense sta- ? 2 on 2 Adult XXX-Large
tions daily ? 3 on 3
1:40 Afternoon Break Make checks payable to:
? Campers will be exposed to out- 1:50 Game--Round 1
Henry County Parks and Recreation
standing speakers on recruiting, 2:10 Game--Round 2
academics and basketball tech- 2:30 Game--Round 3 Mail or bring Registration and Medical
2:50 1 on 1 Contest Forms to:
niques 3:30 Roll Call--Dismissal HCMS Summer Basketball Camp
Attn: Tac Cunningham
166 Holly Smith Drive
McDonough, GA 30253