choctaw nation of oklahoma basketball camp camp 2014.pdf · choctaw nation of oklahoma basketball...
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Choctaw Nation of Oklahoma
BASKETBALL CAMPIDABEL HIGH SCHOOL or
BROKEN BOW SPORTS COMPLEX
July 7 - 8 • 9:00 am - 3:00 pm
CARL ALBERT STATE COLLEGE or
HEAVENER HIGH SCHOOL
July 10 - 11 • 9:00 am - 3:00 pm
RATTAN HIGH SCHOOL or
TALIHINA HIGH SCHOOL
July 14 - 15 • 9:00 am - 3:00 pm
TUSHKA HIGH SCHOOL or
COALGATE HIGH SCHOOL
July 17 - 18 • 9:00 am - 3:00 pm
McALESTER HIGH SCHOOL or
WILBURTON HIGH SCHOOL
July 21 - 22 • 9:00 am - 3:00 pm
SOPER HIGH SCHOOL or
SOSU GYM in DURANT
July 24 - 25 • 9:00 am - 3:00 pm
DEADLINE FOR APPLICATION IS APRIL 18, 2014
Name: Phone:
Address: City: State: Zip:
Age: Date of Birth: Male / Female
Circle T-Shirt Size: Youth (10 - 12) (14 - 16) ; Adult (Small) (Medium) (Large) (X-Large) (2X-Large) (3X-Large)
Have you attended any of our camps? Y N List the camp & how many years:
Do you have insurance? Y N List insurance information:
Emergency contact person & phone #:
Medical Information:
CONSENT: I authorize a representative of the Choctaw Nation Staff, Camp Director, and Instructor to seek medical treatment for my child, if I am not present, while participating in this camp. In consideration of the sponsors and facility owner accepting this application, I hereby release and waiver all rights to any claim for damages and/or injury my child may suffer while participating in this camp. I understand and agree that medical or other services rendered to my child by the camp sponsors/facility owner is not an admission of liability or continued services.
Signature of Parent / Guardian Date
CAMP LISTINGSelect the camp you will be attending. Ages 8 - 18. Deadline: April 18, 2014
Registration: 8:00 am - 9:00 am
NO BUSSING SCHEDULE
JULY 7 - 8 • 9:00 AM - 3:00 PM
Idabel High SchoolBroken Bow Sports Complex
JULY 10 - 11 • 9:00 AM - 3:00 PM
Carl Albert State CollegeHeavener High School
JULY 14 - 15 • 9:00 AM - 3:00 PM
Rattan High SchoolTalihina High School
JULY 17 - 18 • 9:00 AM - 3:00 PM
Tushka High SchoolCoalgate High School
JULY 21 - 22 • 9:00 AM - 3:00 PM
McAlester High SchoolWilburton High School
JULY 24 - 25 • 9:00 AM - 3:00 PM
Soper High SchoolSOSU Gym in Durant
CAMPER MUST WEAR APPROPRIATE SHOESNO FLIP-FLOPS OR SANDALS
CAMPER WILL NOT BE ALLOWED TO PLAY BAREFOOT THIS YEAR
Office Info
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ATTACH COPY OF CHOCTAW MEMBERSHIP AND CDIB
ALL CAMPERS MUST PARTICIPATE! PLEASE NOTIFY CAMP STAFF IF CHILD WILL BE PICKED UP EARLY.
Choctaw Nation of Oklahoma
BASKETBALL CAMPDeadline: April 18, 2014
INSTRUCTIONS:Complete Application and Sign.
Mail to: Choctaw Summer Camp • c/o Kevin Gwin • PO Box 1210 • Durant, OK 747011-800-522-6170 • Fax: 580-920-3129