YOUTH DAY CAMP REGISTRATION FORM Name: ______________________________________________ Indiana State Indiana 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 Basketball Camp, I hereby agree and promise that I will u Each participant will receive a t-shirt, a not hold Indiana State University 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]. TERRE HAUTE, IN 47809 ISU ARENA, SUITE 107 WOMEN’SINDIANA STATE BASKETBALL Indiana State SYCAMORES GIRLS BASKETBALL CAMP As the Head Coach of the Indiana State Sycamores, I am thrilled to invite you to participate in our Sycamore Girls Basketball Camps. Our camps will provide you the opportunity to take your game to the next level. Whether you are just starting your hoops career or you are a long-time player, you will enjoy a great learning experience. I am a very passionate coach with a strong love for the game and our camp staff will work hard to ensure that you have a wonderful experience at Indiana State. We will not only work hard, but we will have a lot of FUN doing it. I look forward to seeing you at camp! Coach Joey Wells ABOUT COACH WELLS Now in his second season at the helm of the Sycamore Women’s Basketball program is head coach Joey Wells. Wells joined the Sycamore program during the 2012-13 season as an assistant coach. He was then promoted to Associate Head Coach prior to the 2013-14 season. In August 2014, Wells became the seventh head coach in Indiana State Women’s Basketball history. YOUTH DAY CAMP Wells has guided Indiana State to a regular season Missouri Valley Conference title (2013-14) and a 38-25 overall record in three seasons(24-12 in Missouri Valley Conference June 20-23, 2016 play). Coach Wells has also acted as the team’s defensive Girls Entering Grades K-8th coordinator for the past three seasons, where ISU has held 15 For more information or to pay online, visit: opponents to 50 points or less. http://sycamoreswbbcamps.com/.