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