SINCE 1988 Toowoomba Supercamp - January 8th to 12th, 2022 The Glennie School Accommodation at The Glennie School For Boys and Girls, Ages 6 - 18 years, ALL SKILLS LEVELS

BASKETBALL CAMP COACHES: Nathan Sobey Current Olympic Team Member (Boomers) A Typical Day at Current Bullets - NBL All-Star player Played at University of Wyoming Supercamp 3 SESSIONS PER DAY 7:00 - 8:00am Clarence ‘POP’ Brian Kerle Breakfast for Live-in campers 2 time NBL Coach of the Year Dickerson Won 4 NBL Championships as Head coach Former Head Coach Toowoomba Former Head Coach (NBL) Mountaineers (QBL) Former Head Coach St Kilda (NBL) Former Head Coach Gold Coast Morning Session Warriors (ABA) Former Australian Asst. Coach Men’s Olympic team ABA Nth Conference All-Time Leading Current director of BasketballTek Academy 9:00 - 11:30am Scorer - 10 seasons, 30pts/per game Skills training - passing, Former NBA Draftee Washington Wizards SUPERCAMP DIRECTOR shootIng, ball handling, rebounding etc... Thalo Green Played for the Denver Nuggets (NBA) Played for the Tigers (NBL) Played for Brisbane Bullets (NBL) Played for University of Washington 12:00 noon Played for Cairns Tiapans (NBL) Played for (NBL) Lunch - Freetime Top Junior Coach Top Junior Coach

Afternoon Session 1:30 - 4:30pm Despena Dickerson Marty Nolen Competition Games Current Toowoomba Mountaineers Player- League Player - Queensland Basketball League Former Toowoomba Mountaineer QBL 1-on-1, 2-on-2, 5-on-5 - current Logan Thunder Player SBL 4:30 - 5:00pm Swimming 5:30 - 6:15pm Karina Agius Dinner Former WNBL 1 Coach Top Junior Coach Evening Session (NOT COMPULSORY FOR 9 YEARS AND UNDER PLAYERS) SOUTHWEST QUEENSLAND 6:30 - 7:30pm SPORT & REC. ASSOC. Competition Games 10:00pm Lights out

Go to supercamp.com.au for registration or phone 0417 196 151 SUPERCAMP @SUPERCAMP4 the Glennie School, 41 Vacy St

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The Glennie School

The Glennie School

04/01/2022.

Shorts, Singlets, T-shirts SUPERCAMP Basketball Registration Form

Toowoomba Supercamp - January 8th to 12th, 2022 The Glennie School, Toowoomba, Queensland Accommodation at The Glennie School

Name………………………………………………………………….. Male…………. Female…………………………………… Address…………………………………………………………………..………………...... P/C …………...... Age at Camp ………….. Date of Birth ……….…. Ph ………………………………. Mob.……………………………………… Email ………………………………………………………….…………………………………………………………………………. I will be attending as a : Live-In Camper OR Live-Out Camper Preferred Playing Age: 6/7/8yrs 9/10yrs 11/12yrs 13/14yrs 15/16yrs 17/18yrs T-Shirt Size: 8 10 12 14 sm med lge xlge I will be travelling to the camp by: Private Vehicle Bus Airline Train I would like to be collected and dropped off at terminal: Yes No Please provide arrival and departure details to Supercamp in writing or in Special Request section. Special Request:...... I give permission for photographs/film that may include my child to be taken by Supercamp staff for use in Supercamp promotions: Yes No Please post me ...... additional forms for my friends How did you hear about Supercamp ......

TOOWOOMBA SUPERCAMP REGISTRATION FEES 5 DAY LIVE-OUT CAMP $225 $ (Evening training sessions are NOT COMPULSORY for 9 years and under campers) + 5 DAY LIVE-OUT LUNCH PACKAGE (optional) $50 $ + 4 DAY LIVE-OUT DINNER PACKAGE (optional) $50 $ 5 DAY LIVE-IN CAMP (Includes 3 meals per day & 24 hr supervision) $575 $ 5 DAY PARENTAL LIVE-IN CAMP $575 $ (Includes all meals and accomodation. Parents housed separtely from campers) + EXTRA NIGHT/S ACCOMMODATION $50/NIGHT $ (Before and/or after camp. Does not include meals)

(Pay in full by 07/10/2021 and receive $50 off camp fee)

(Pay in full by 07/10/2021 and receive $25 off camp fee)

PLEASE CONTACT SUPERCAMP HEADQUARTERS FOR GROUP BOOKING DISCOUNTS

I am paying by: Mastercard Visa EFT AMOUNT PAYING $ CARD # - - - EXPIRY: / CARDHOLDER’S NAME : SIGNATURE: Please make cheques or money orders payable to Basketball Supercamp and forward to PO Box 183 Toowoomba, Queensland, Australia 4350 or email registration form to [email protected] EFT BSB: 638-070 A/C #: 13077295 A/C name: Southwest Queensland Sport & Rec Assoc Bank: Heritage EFT REFERENCE: Participant’s Name

Mob: 0417 196 151 Email: [email protected] SUPERCAMP MEDICAL FORM

Name:...... Address:...... Age: ...... DOB: ...... Male / Female

Which camp(s) attending?...... Home Ph: ...... Work Ph: ...... Email Address:...... Mothers Name: ...... Fathers Name: ...... Guardian......

JULY Toowoomba Basketball Supercamp JANUARY Toowoomba Basketball Supercamp

Medical Details Medicare No: ...... Do you have current ambulance cover? Yes / No (circle) Do you have current private health insurance? Yes / No (circle) Are you on a special diet? Yes / No If yes, please give details ...... Do you have any medical condition(s) or disabilities we need to know about? Yes / No If yes, please give details ......

Emergency Contacts Name:...... Mobile Phone No: ...... Work Phone No: ...... Name of your Doctor: ...... Your Doctor Phone: ......

Release & Waiver of Liability Should a camper leave the camp because of injury or illness no refund will be given. Supercamp reserves the right to cancel the camp at any me. Should a camp be cancelled all monies will be refunded. While par cipa ng in physical ac vi es each par cipant is assumed to be voluntarily performing these ac vi es for which he/she assumes all risk, consequences and poten al liability. Supercamp reserves the right to search rooms and bags and con scate any items which do not conform to camp rules. The Supercamp and its sta shall not be held responsible by reason of accident, illness, injury, death and other consequences arising or resul ng directly for par cipa ng in Supercamp. The Supercamp and its sta shall not be held responsible for any medical cost by reason of accident, illness, injury, death and other consequences arising or resul ng directly from par cipa on in Supercamp. Should a camper become ill or injured Supercamp will transport camper to local base hospital or call an ambulance. Lost key will incur a $25.00 penalty. Some mes due to unforeseen circumstances coach(s) promoted to a end the Supercamp may be unable to do so; however, Supercamp will always provide a high quality coaching sta Cancellations All cancella ons must be made in wri ng and post marked or e-mailed 30 days prior to the 1st day of the camp. Should you cancel within 30 days of the camp you will incur a 50% cancella on levy, alternately your posi on can be held over for the next Supercamp of your choice regardless of loca on. Campers cannot be guaranteed a t-shirt if they register after the 1st deadline 01/01/22 I have read and understood the above Release and Waiver of Liability Parent or guardian Signature: ______Date: / /

Return to: PO Box 183 Toowoomba Q. 4350 or [email protected]