The Sydney Johnson Basketball Camp Application Form The Sydney Johnson Boys 6 years old (at time of camp) or older who have NOT entered into the 9th grade (Please print clearly) BASKETBALL CAMP NAME AGE/GRADE entering in Fall SUMMER 2016 DAY CAMP Typical Camp Daily Schedule STREET ADDRESS 8:45 a.m. ............. Drop off CITY STATE ZIP CODE 9 a.m. ............. Camp begins 9:15 a.m. ............. Stations TELEPHONE EMERGENCY TELEPHONE # 10:15 a.m. ............. Games Noon ............. Lunch E-MAIL 12:30 p.m. ............. Lecture INSURANCE CARRIER 1:30 p.m. ............. Stations 2:30 p.m. ............. Games INSURANCE I.D. NUMBER 3 p.m. ............. Dismissal/Pick-up ! (This is a tentative schedule for weekday day camp.) PARENT’S SIGNATURE Note: Friday 9 a.m. – Noon Tuition (Includes insurance, t-shirt) Check applicable weeks: *NO SUPERVISION WILL BE PROVIDED PRIOR TO 8:30 A.M. o June 27 – July 1 ....................................................$340 OR AFTER 3 P.M. o July 4 – 8 ...............................................................$340 please detach to mail o August 1 – 5 ..........................................................$340 THIS CAMP IS IN COMPLIANCE WITH THE REGULATIONS OF THE STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH • Groups of 5 or more registering together - $310 per person Sydney Johnson, Head Men’s Basketball Coach at Fairfield University • Early Bird Special: Register before April 1 - $325 per person AND IS LICENSED BY THE BOARD OF HEALTH. T-shirt — Check applicable size (adult sizes): BACKGROUND CHECKS AND THREE POSITIVE REFERENCES o Small o Medium o Large o Extra Large HAVE BEEN PROVIDED FOR ALL CAMP STAFF. June 27 – July 1 (Grades 1-8) July 4 – 8 (Grades 3-8) Please make check payable to “The Sydney Johnson August 1 – 5 (Grades 1-8) Basketball Camp”, sign application, and mail to: Men’s Basketball Office Monday – Thursday 9 a.m. – 3 p.m. Fairfield University Friday 9 a.m. – Noon Walsh Athletic Center (WAC 224B) 1073 North Benson Road Fairfield, CT 06824-5195 1073 North Benson Road Fairfield, CT 06824 A non-refundable deposit of $100 is required with application. fairfieldstags.com Full balance due no later than 3 days prior to the start of camp. Any balance not paid 3 days prior to the start of camp must be For more information, please call K. Koncz 203-254-4000, ext. 2791 or e-mail [email protected] paid in cash on the first day of camp. 41147_3.16 The Sydney Johnson BASKETBALL CAMP at Fairfield University About the Camp Camp Details Registration and Facilities Sydney Johnson Lunch Registration In Sydney Johnson’s fifth year as Campers can bring their own lunch or soft drinks; pizza Submit one application per child and a non-refundable, non-trans- the Stags head coach Fairfield has and snacks will be sold daily at the canteen. ferable deposit of $100 per week. Final payment and completed seen an offensive output never Youth Camp Health Exam/Record Form must be received prior to before seen in the program’s check-in. history. During the 2015/16 season What to Bring the Stags have reached the 100 • T-shirt Registration will be held on the first morning of each session point mark twice, with both scoring • Shorts beginning at 8:45 a.m. at Fairfield University’s Alumni Hall. Any outbursts coming on the road. In • Socks balance not paid 3 days prior to the start of camp must be paid both of those games the Stags hit Head Coach, Sydney Johnson • Lunch on the first day of camp. a school record 17 three pointers. • Basketball sneakers Fairfield has consistently ranked in the top 50 in the nation in many offensive categories during the 15/16 season (pace of play, points per • Sunscreen Fairfield University Alumni Hall and game, total 3PT field goals made, and assists per game). The camp will not be responsible for any items of value that campers Recreational Complex Prior to coming to Fairfield, Coach Johnson, led Princeton University bring to camp (i.e., clothing, jewelry, backpacks, money, etc.). The camp is conducted on to the 2010-11 Ivy League Championship, and an automatic berth to Fairfield University’s 200-acre the NCAA tournament. Princeton took the University of Kentucky to the Medical Information campus. All games and final seconds before dropping a 59-57 decision. activities take place in Alumni The Youth Camp Health Exam/Record Form must be completed and Hall and the Leslie C. Quick Jr. signed by the camper’s physician, APRN, or PA and returned before The Camp Recreation Complex (RecPlex). the start of camp. Campers must submit a new form each year. • Coach Johnson and his staff of professional educators teach The facilities are adjacent to Campers with allergies must also have the Authorization for the basic fundamentals to advanced theory. each other and located about one quarter mile on the left from the Administration of Medication form completed and signed. • The staff-student ratio ranges from 1:8 to 1:10. main entrance to campus. • Teams are coached by college coaches, high school • Six full indoor basketball courts coaches, and college players. • Two full outdoor courts • Each student plays on a team with players of his own age and ability. • Completely equipped training facility • Students play at least half of every game. • Full-time trainer on premises • Students work on skills like ball handling, balance, defense, • Camp supervision and security at all times dribbling, rebounding, passing, and shooting. • Camp counselors include current Fairfield University • Students are taught conditioning exercises and drills student-athletes used by college and pro players, as well as challenge and motivation techniques for the off-season. • One of the fastest growing camps in the area. Other Features NO SUPERVISION WILL BE PROVIDED • Stations for individual instruction PRIOR TO 8:30 A.M. OR AFTER 3 P.M. • Certificates and awards • Individual competition events • Camp t-shirts (one per camper) • Basketball.