1. Kelsi Musick - WBB- Fundamental Day Camp
Coach Musick & Coach Evans
2019 BASKETBALL
FUNDAMENTAL DAY CAMPS
Grades: K - 6th grade
9am - 12pm (Boys & Girls)
Dates Offered:
June or July 22-24
Site: SWOSU Wellness Center Cost: $115.00/camper
For more information contact Kelsi Musick or Cophie Anderson or
580/ or 816/
Name:_____________________ Address:_________________________________
City ________________________________ Zip________________
Home Phone:________________ Emergency Phone:_____________________
address:____________________________________________
Age:______Grade (just completed):________School:_________________________
CAMP SESSION (circle date) : (June 24-26) (July 22-24)
T-SHIRT SIZE (circle one) : Youth: S M L Adult: S M L XL
Liability/Insurance Statement
I hereby authorize the staff of Kelsi Musick Basketball Camp to act for me according to their best judgment in any emergency requiring medical attention and I waive and release the camp from any/all liability for injuries incurred while at camp.
_______________________________________________________________________________________
Parent/Legal Guardian Signature Date
Please list all previous health conditions the Camp staff needs to be aware of (i.e. asthma, concussions, allergies, injuries,etc.)____________________________________________________________________
Insurance Company________________________________ Policy #________________________________
Please return this portion along with payment to:
Kelsi Musick - WBB- Fundamental Day Camp
100 Campus Dr.
Weatherford, OK 73096