2012

Girls Basketball Day Camp

Entering Grades 4-12

Week 1: June 25 - June 29

Week 2: July 30 - August 3

Centenary College named Justin Phoenix

it’s head women’s basketball coach on September 1,

2011. Phoenix comes to Centenary after spending

three seasons at Kean University, where he was an

assistant for the women’s basketball team. During

his tenure at KU, the team went 75-15 with one New

Jersey Athletic Conference (NJAC) Championship,

three NCAA Tournament appearances and two

Sweet Sixteen runs. He helped develop three All-

Americans, two NJAC Players of the Year, one

NJAC Defensive Player of the Year and one player

playing Professional Basketball in Puerto Rico.

Chelsea Wolf

Assistant Coach

Co-Camp Director

Erin Geary

Assistant Coach

Co-Camp Director

Phone:: 908-852-1400 ext. 2194 E-mail: phoenixj@centenarycollege.edu

Name _________________________________

Address _________________________________

City ________________________ State _____

Zip_________

Age _____ Height _______ Weight ______

DOB _____________________

Home Phone:_________________________

Parent/Guardian Phone ___________________

Parent Name(s) ____________________________

School__________________________________

Grade (Fall 2012) ______

Coach ______________________

T-Shirt Size (circle): S M L XL *** LUNCH IS INCLUDED. PLEASE PROVIDE YOUR CHILD W/ CANTEEN MONEY, AS SNACKS, DRINKS, AND CANDY WILL BE FOR SALE

Please check all that apply: Week 1 - June 25—29 — $200 Week 2 - July 30—August 3 — $200 Both Camps — $350 Early Registration: (Deadline - April 24th) — $180 Group Discount: (8 or more: Deadline - April 30th) $175 Only ONE discount can be applied to a camper or group of campers. (*Discounts may not apply for students entering grades 9-12)

Personal Checks and cash will only be accepted at registration for the remaining balance.

Enclosed is my check for ___________ (full payment) Enclosed is my check for $100 (*non-refundable deposit to ensure my daughter’s enrollment in the camp) *Non-refundable deposit is $100 per week of camp attended Please make checks payable to: Centenary College Please detach application and mail with check to: Centenary College Women’s Basketball Camp 400 Jefferson Street Hackettstown, NJ 07840

www.centenarycyclones.com

Detach Here

Centenary Women’s Basketball Day Camp

WEEK 1 Mon - Fri - June 25 - June 29 9:00 am - 4:00 pm - $200

WEEK 2 Mon - Fri - July 30 - August 3 9:00 am - 4:00 pm - $200

9:00 AM Attendance

9:30 AM Stations

10:30 AM Games

11:30 AM Contests

12:30 PM Lunch

1:30 PM Attendance

1:45 PM Lecture

2:15 PM Games

4:00 PM Camp Ends

Daily Schedule

Lunch is included. Please provide your child with canteen money as snacks, soda and candy will be for sale. This camp is not responsible for any article/property lost or stolen. This camp is open to any and all entrants (limited only based by number, age, grade level and/or gender.

INDIVIDUAL SKILL SESSIONS

Want to improve your game? Individual skills sessions will be available after camp every day except on Fridays. One of the camp directors will be available to teach any skill you would like to improve on (i.e. shooting, dribbling) Each skill session will last an hour with a charge of $50. Please let Chelsea Wolf or Erin Geary (Co-Camp Directors) know ahead of time if you are interested.

For more information, please call: (908)852-1400 ext 2341 Or Email: wolfc@centenarycollege.edu gearye@centenarycollege.edu

MEDICAL RELEASE FORM

I herby give permission for _____________to participate in

the 2012 Centenary College Women’s Basketball Camp. I

certify that my daughter is in good physical condition, has

been examined within the last 12 months and no medical

reason has been found that she cannot participate in this

camp. Records show that all immunizations are up to date. I

understand that she will be participating in rigorous play

and activity. Centenary College Personnel have also been

informed of any physical limitations, medications or prior

conditions. The camp will safeguard the health of my child

but will not be responsible for accidents, injuries or

sickness on the way to camp, during camp or on the way

home.

I agree that in the case of an accident involving my child

while attending camp, and with full awareness that

basketball is an activity that may involve risk or injury, I

release Justin Phoenix and Centenary College from any and

all liability. I herby request that my child be granted

admittance into the 2012 Centenary College Women’s

Basketball Camp and authorize the directors to act on my

behalf in the event of an emergency requiring medical

attention. I will assume responsibility for payment for any

such attention and have provided current insurance

information as requested.

Camper Name __________________________Age_____

Parent(s) Name(s) ______________________________

Parent(s) Daytime Phone ________________________

Home Phone ____________________________ ______

Emergency Contact _____________________________

Relationship ___________________________________

Contact Phone# ________________________________

Insurance Carrier_______________________________

Policy#_______________________________________

Previous Medical Conditions _______________________

By Signing below, I agree to all the terms detailed above

Parent/Guardian Signature _________________________

Date_______________