RELEASE AND WAIVER

RELEASE AND WAIVER

I hereby and herein authorize the Director of the Lady Pioneer Basketball Camp, LLC or any agents working on their behalf, to act in my stead for the purpose of acquiring emergency medical attention for my daughter or ward. I impose upon the assumptors of this duty the responsibility to act with reasonable care and caution and release and waive all liability for any injuries and illness incurred while at the camp in the event the same is performed pursuant to such standard. By my signature hereunder, I warrant that my daughter or ward is in good physical condition, has no undisclosed medical problems, illnesses or disabilities, and is capable of full and active participation in the basketball camp. I also represent that my daughter or ward has received a physical within the last year and is medically competent to participate in the activities at camp.

Signature of Parent or Guardian_______________________________________

Date___________________________________________________________

Confirmation: Upon receipt of the camper's registration and deposit, a confirmation letter will be emailed or mailed to you. Your confirmation letter will provide you with complete information regarding all details of camp.

Payment: A $100 non-refundable deposit and/or full payment must accompany all registration forms for each resident or commuter camper by July 15.

Please make checks payable to: Lady Pioneer Basketball Camp, LLC

Mail your registration to: Kole Vivian/Head Women's Basketball Coach Marietta College 215 Fifth St. Marietta, OH 45750

Women's Basketball 215 Fifth Street, Marietta, OH 45750-4013

RESIDENTIAL CAMP

JULY 21-23, 2019 RESIDENT-$250, COMMUTER-$190 GIRLS ENTERING GRADES 5-10

CAMP INFORMATION

"The offseason is a time for basketball players to improve their individual skills. It is my desire as head women's basketball coach at Marietta College to help each player reach their fullest potential in all aspects of their game. Our goal is to ensure that each camper has a rewarding and positive experience at our camp. Camp will be run by my experienced staff and current collegiate players providing individualized instruction."

-- Kole Vivian, 2018 OAC & Great Lakes Region Coach of the Year Finalist for 2018 National Coach of the Year

What to Bring: Change of clothes for each day, socks, shoes, water bottle, bed linens, shower supplies, towel, fan, snacks for the dorm.

Emphasis On: fundamentals, shooting, rebounding, ball handling, footwork, passing, defense, offense.

Facilities: Camp each day will be held in the newly renovated and air conditioned Dyson Baudo Recreation Center and Fenton Court.

Housing/Meals: Resident campers will be housed on the beautiful campus of Marietta College. Coaches and counselors will reside on the same floor as the campers. 24 HOUR SUPERVISION IS PROVIDED. All meals will be provided from our on campus dining services. The campers' registration fee covers the cost of all meals. Commuters will be provided lunch and dinner meals. Commuters are campers who elect not to stay in the residence hall. Each camper is responsible for her meal before the first session of camp.

Sunday, July 21, 2019 4:30-5:45 p.m.. . . . . . . . Check In 6:00-9:00 p.m.. . . . . . . . Session I

Monday, July 22, 2019 7:45-8:30 a.m.. . . . . . . . Wake-Up/Breakfast 9:00 a.m.-12:00 p.m.. . . Session II 12:00-2:00 p.m.. . . . . . . Lunch/Rest 2:00-5:00 p.m.. . . . . . . . Session III 5:00-7:00 p.m.. . . . . . . . Dinner/Rest 7:00-10:00 p.m.. . . . . . . Session IV/Movie

Tuesday, July 23, 2019 7:45-8:30 a.m.. . . . . . . . Wake Up/Breakfast 9:00-11:30 a.m.. . . . . . . Session V 11:30-2:00 p.m.. . . . . . . Lunch/Rest 2:00-4:30 p.m.. . . . . . . . Session VI 4:30-5:00 p.m.. . . . . . . . Awards Ceremony 5:00-6:30 p.m.. . . . . . . . Check Out

ALL campers must check in at Ban Johnson Arena on Sunday afternoon.

Commuters should be picked up at 9:00 p.m. on Sunday and 10:00 p.m. on Monday evening and dropped off by 8:45 a.m. on Monday and Tuesday morning at Ban Johnson Arena.

Please contact Head Coach Kole Vivian for any questions: 740-376-4586 or kmv001@marietta.edu

DAILY SCHEDULE

REGISTRATION FORM

CAMPER INFORMATION

Name__________________________________________________________

Address_________________________________________________________

______________________________________________________________

city

state

zip

Cell Phone_______________________________________________________

Emergency Contact________________________________________________

Emergency Contact Phone___________________________________________

Grade Entering Fall 2019____________________________________________

Age____________________________________________________________

Commuter or Resident______________________________________________

Roommate Preference______________________________________________

Health and Accident Insurance Carrier___________________________________

Policy #_________________________________________________________

Physicians Name and #_____________________________________________

Dentists Name and #_______________________________________________

Camp T-Shirt Size_________________________________________________

PARENT INFORMATION Name__________________________________________________________ Home Phone_____________________________________________________ Cell Phone_______________________________________________________ Email__________________________________________________________ Name__________________________________________________________ Home Phone_____________________________________________________ Cell Phone_______________________________________________________ Email__________________________________________________________

Lady Pioneer Basketball Camp, LLC is not responsible for any injuries sustained by a participant or camp employee. (Please complete the other side.)

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