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REGISTRATION FORM
Campers Name:________________________________________________________________Date of Birth:_________________
Address:________________________________________________City:______________________Zip:_____________________
Parents/Guardian Names:_________________________________ Phone#:_______________
Entering Grade: (Circle one) 4th 5th 6th 7th 8th
Campers T-shirt Size: (Circle one) Youth: Small Medium Large Adult: Small Medium Large
Indemnity Waiver and Parent Consent Form
I hereby request that you accept this registration form for the Wampus Cat Basketball Camp during the dates set forth in the application. I hereby release Conway Public Schools and all of its employee’s from any claims on account of injuries that may be sustained by the participant while attending this Camp. Each participant should have his/her own medical insurance.
___________________________________________________________________________ Date:______________________________
Signature of Parent/ Guardian
Make Checks payable to:
Conway Athletic Booster Club
Please mail or return registration form and payment to the Athletic office in Buzz Bolding Arena.
Athletic Office
Attn: Coach Will Johnson
2300 Prince St. Conway, AR 72034
Camp Information
The camp will be run by the Conway Wampus Cat Basketball coaches and players.
Each camper will receive a T-shirt.
Prizes will be awarded to winners of contests.
Participants will be drilled on basic fundamentals, participate in live scrimmages, obstacle course, hot shot, knock out, etc.
Please direct any questions to 450-6631 or email Coach Will Johnson
June 15,16,17 @ Buzz Bolding Arena
Session 1: 4:00-6:00 pm entering grades 4-6
Session 2: 6:15-8:15 pm entering grades 7-8
The Cost is $40 a camper.
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