YOUTH DAY CAMP REGISTRATION FORM Name: ______Indiana State State Address: ______City/State/Zip: ______Email: ______SYCAMORES SYCAMORES Home Phone: ______Cell Phone: ______Grade Fall 2016: ______T-Shirt Size: ______

MEDICAL CONSENT FORM Youth Day Camp Youth Day Camp **EVERY CAMPER MUST COMPLETE THIS SECTION RELEASE FOR MEDICAL TREATMENT WHEN Waiver and Release for:______CAMP FEATURES In consideration for my daughter’s participation in the 2016 Indiana State June 20-23, 2016 Sycamores Girls Camp, I hereby agree and promise that I will u Each participant will receive a t-shirt, a not hold nor its employees responsible for any loss, WHO basketball, and much more! damages, or personal injuries that she may receive as a result of participation. Open to Girls entering Parent/Guardian Name: ______Grades K-8th in Fall 2016 u Instruction is geared towards basketball’s Parent/Guardian Signature: ______Date: ______fundamental skills and techniques. TIME Work Phone: ______Home Phone: ______Cell Phone: ______9:00 am to u Players will be introduced to various 4:00 pm offensive and defensive skills of basketball. AUTHORIZATION FOR TREATMENT I hereby give permission to the physician selected by the camp to provide COST u Players will be instructed by well-qualified treatment for my child while at the ISU Sycamores Girls Basketball Camp. staff and will participate in station work, drills, Parent/Guardian Signature: ______$150 per person Date: ______and various competitions to help in basketball development. LOCATION ADDITIONAL INFORMATION ISU Arena, Drug/Food Allergies: ______ADDITIONAL INFORMATION Last Tentanus Immunization Date: ______Terre Haute, IN Current Medications: ______Lunch will be at the ISU Commons. Camp participants Physical Reactions:______REGISTRATION will need to bring lunch money or bring a sack lunch. Other Concerns: ______DEADLINE A camp store will be available for snacks and ISU gear. Athletic trainers will be on staff for basic athletic training Please return this application with your payment to: ISU Girls Basketball June 13, 2016 needs. All camps/clinics are open to any and all entrants (limited only by number, age, grade level and/or gender). Camp, ISU Arena, Ste. 107, Terre Haute, IN 47809 or Fax to 812.237.7974 ($75 deposit due) For more information, call 812.237.8357 or email [email protected]. June 20-23, 2016 20-23, June YOUTH DAY CAMP DAY YOUTH Girls Entering Grades K-8th Grades Entering Girls http://sycamoreswbbcamps.com/ GIRLS BASKETBALL CAMP For more information or to pay online, visit: online, pay to or information more For

INDIANA STATE WOMEN’S BASKETBALL ISU ARENA, SUITE 107

TERRE HAUTE, IN 47809

Coach Joey Wells Joey Coach

I look forward to seeing you at camp! at you seeing to forward look I

a lot of FUN doing it. doing FUN of lot a

State. We will not only work hard, but we will have have will we but hard, work only not will We State.

that you have a wonderful experience at Indiana Indiana at experience wonderful a have you that

game and our camp staff will work hard to ensure ensure to hard work will staff camp our and game WELLS COACH ABOUT

a very passionate coach with a strong love for the the for love strong a with coach passionate very a

player, you will enjoy a great learning experience. I am am I experience. learning great a enjoy will you player,

starting your hoops career or you are a long-time long-time a are you or career hoops your starting

your game to the next level. Whether you are just just are you Whether level. next the to game your

Our camps will provide you the opportunity to take take to opportunity the you provide will camps Our

Sycamore Girls Basketball Camps. Camps. Basketball Girls Sycamore Coach Wells has also acted as the team’s defensive In August Wells 2014, became the seventh head coach in Wells has guided Indiana State to a regular season Wells joined the Sycamore program during the 2012-13 Now in his second season at the helm of the Sycamore

I am thrilled to invite you to participate in our our in participate to you invite to thrilled am I As the Head Coach of the Indiana State Sycamores, Sycamores, State Indiana the of Coach Head the As coordinator for the past three seasons, where ISU has held 15 opponents to 50 points or less. record in three seasons(24-12 in Missouri Valley Conference play). Missouri Valley Conference and title a 38-25 (2013-14) overall Indiana State Women’s Basketball history. Associate Head Coach prior season. to the 2013-14 season as an assistant coach. He was then promoted to Women’s Basketball program is head coach Joey Wells.