Parental Waiver & Consent Form SJR BASKETBALL Annual …

[Pages:2]Parental Waiver & Consent Form

As the parent or legal guardian of the child named below, I give my full consent and approval for my child to participate in the sport(s) designated below.

I understand that there are certain risks of injury inherent in the practice and play of this sport, as well as in traveling and other related activities incidental to my child's participation, and I am willing to assume these risks on behalf of my child. I hereby certify that my child is fully capable of participating in the designated sport and that my child is healthy and has no physical or mental disabilities or infirmities that would restrict full participation in these activities, except as listed below.

In addition to giving my full consent for my child's participation, I do hereby waiver, release and hold harmless the organization named below, its officers, coaches, sponsors, supervisors, representatives and the owner of the athletic field for any injury that may be suffered by my child in the normal course of participation in the designated sports and activities incidental thereto, whether the result of negligence or any other cause.

GREEN KNIGHTS BASKETBALL CAMP

Period of Authorization:

Session 1_____ Session 2_____ Session 3_____

_________________________________________ Name of Child

__________________________________________ Date of Birth

__________________________________________ Parent Signature

Please list any physical limitations (allergies, hearing, sight, etc)

___________________________________________

___________________________________________

SJR BASKETBALL

Bergen County Champions

1981, 1982, 2005, 2016

League Champions

1980, 1981, 1988, 2005, 2007, 2009, 2010

B.I.T. Champions

2012, 2018

Bergen County "Team of the Year"

1981, 1982, 2005, 2007

Welcome to the 31st Annual

Green Knights Basketball Camp

3 Sessions: July 8-11 July 15-18 July 22-25

****************** *Register by May 1st* & receive $25 discount off one week's cost ******************

Register Early Before Sessions Are Sold Out!

******************

Camp Director ? Michael Doherty Head Coach at

St. Joseph Regional HS

Location St. Joseph Regional HS 40 Chestnut Ridge Rd

Montvale, NJ 07645

Time 9:00am to 3:00pm (M-Th)

Who May Attend Boys ages 8-15

(Campers grouped by age & ability)

Cost 1 week = $245 2 weeks = $470 3 weeks = $675

Staff SJR basketball coaching staff; other

top area high school & college coaches; college players; & high

school players as counselors

CAMP FEATURES

*FREE official size & weight basketball*

*Top Lecturers* *Development of individual & Team offensive & defensive skills* *Individual Teaching Stations* *Two League Games per day* *Official GKBC Booklet* *FREE Camp T-Shirt* *Written evaluation by coach* *Full time Trainer*

Facilities

*SJR Gymnasium *Outdoor Courts *Locker Rooms *Cafeteria

What to Bring to Camp Sneakers, t-shirt, shorts, sweat socks,

towel, lock & lunch (camp provides drink)

**Pizza available for purchase each day**

2019 GKBC Registration Form

Name___________________________________

(Last)

(First)

Address_________________________________

(Number)

(Street)

________________________________________

(Town)

(State)

(Zip)

Phone___________________________________ Email___________________________________ Grade in Sept. 2019 __________ Age__________ School Attending __________________________ T-Shirt Size (Adult): S M L XL

(Circle One) ______ Session I (July 8-11) ______ Session II (July 15-18) ______ Session III (July 22-25)

(Check All That Apply)

How did you hear about this camp?

Website___ Mail___ Email___ Newspaper___ Other________________________________

A non-refundable deposit of $125 required with application. Balance due on or before July 1st.

Checks payable to: Green Knights Basketball Camp.

Mail to: GKBC, Saint Joseph Regional H.S. 40 Chestnut Ridge Road Montvale, NJ 07645

Parent/Guardian signature Required on reverse side

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