Girls Camp

August 11-14 at St. Margaret’s School, 6:00-9:00 p. m.

Registration Fee:  $125

Boys Camp

August 5-8 at St. Margaret’s School, 6:00-9:00 p. m.

Registration Fee:  $125

Contact for more information:

Brett Westcott, Women’s Coach: 388-9807, westcott@shaw.ca

Camp registration limited to 40 athletes each week!

CHARGE UP YOUR GAME

BASKETBALL ELITE CAMPS

Registration Form

NAME: ____________________________________________________

BIRTHDATE: _____________ AGE: _________  GRADE: __________

SCHOOL: ___________ COACH: ______________________________

ADDRESS: ____________________________

CITY: ______________________ POSTAL CODE: ________________

HOME PHONE: _______________ CELL PHONE: ________________

EMAIL ADDRESS___________________________________________

PARENTS/GUARDIANS NAMES: _____________________________

EMERGENCY CONTACT:

NAME:_______________________________   PHONE:_____________

INDICATE SESSION YOU WISH TO ATTEND:

BOYS (grades 6-8) – August 5-8, 6:00-9:00 p. m.        ______

BOYS (grades 6-8) – August 11-14, 6:00-9:00 p. m.    ______

T-SHIRT SIZE: __________          

WAIVER AND MEDICAL RELEASE

I acknowledge participation in basketball and competitive athletics has an inherent risk. I certify athlete named above is in good health and they are able to participate in the academy activities without limitation.  I hereby authorize the directors and instructors of the Chargers Basketball Elite Camps program to act for me according to their best judgment in any emergency requiring medical attention.

I hereby agree not to sue and to waive the coaches and the directors of the Chargers Basketball Elite Camps, the Vancouver Island Basketball Association and its directors, Camosun College, St. Margaret’s School, the Greater Victoria School Board and any guest coaches or presenters from any and all liability which may arise from my child’s participation in this program, including playing in the sessions and while traveling to and from these events. I acknowledge I am responsible for any and all medical expenses incurred due to my child’s illness or injury during her participation in this program.

We realize all monies paid will be forfeited without claim if the athlete is removed from the camp for their behaviour or if they decide to cease participation with the team and the program for any reason.  We agree to follow all the coaches’ reasonable rules and instructions for the duration of this Chargers Basketball Elite Camps program.

PARENT / GUARDIAN SIGNATURE:                                  Date__________________

_____________________________________________________________________ 

                 _____________________________________________________________________

Athletes will be contacted by email with confirmation of registration.

MAKE REGISTRATION CHEQUES FOR $125 PAYABLE TO:  Camosun College Basketball

Complete and Return Form with Payment to:

Brett Westcott, Chargers Coach

#441-40 Gorge Road West

Victoria, B. C., V9A-1L8