Lady Cougars 2011 Basketball Camp
7740 Old U.S. 50, Breese, IL 62230
Phone: 618-526-4578 ext. 220
Dates: Monday, June 13th through Thursday, June 16th.
Sessions: 1. 8:00-10:00 a.m.- All girls that will be entering grades 3-8 next year.
Grades 3-5 will be in the east gym, grades 6-8 are in the west gym.
2. 10:15 a.m.-12:15 p.m.- All girls that will be entering grades 9-12 next year.
Camp Staff: Current Central Cougars Girls Players and the coaching staff.
Cost: The camp will cost $45.00 per camper.
o Each camper will have an opportunity to win prizes in a variety of competitions.
Name:___________________ Grade (Fall ’11):__________ Birthdate:_______
Address:__________________ City:_________________ Zip: ____________
Phone #:__________________ Emergency Phone #:_____________________
As the responsible party for the previously mentioned camper, I grant permission for her to attend the Lady Cougars Basketball camp. I understand that neither Central High School or the Lady Cougars Basketball Camp provide insurance coverage for any accidental injury sustained by my daughter as a result of her participation in the activities of the camp. In the event of such an injury I will not hold Central High School or the Lady Cougars Basketball Camp liable.
T-Shirt Size (Circle one): Childs: M L Adult: S M L XL
Mail application form and check to:
C.C.H.S. Lady Cougars Basketball Camp, c/0 Nathan Rueter, 7740 Old U.S. 50, Breese, IL 62230
Please make checks payable to: Lady Cougars Basketball Camp