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TOM CREAN BASKETBALL CAMPS


All camps open to all and any entrants

FOR ADDITIONAL INFORMATION:


- Phone: 1-812-855-2238
- E-Mail: For Further Information!
- Register On-Line: Coming Soon!
- Download Camp Brochure: Coming Soon!



2013 Little Hoosiers Basketball Academy

This Camp is SOLD OUT. No additional registrations can be accepted.
 
Registration Note Registrations will be accepted until the camp is full. No refunds or cancellations will be accepted once camp starts. Cancellations received before July 1 will receive a full refund minus a $25 administrative fee. Cancellations received from July 1 until camp opens will be refunded their camp payment minus a $100 late cancellation fee.

Once you have submitted your registrations you will receive a confirmation letter, complete camp information, a campus map and a medical history form that should be filled out and brought with you to registration. You also will be required to bring a physician's statement or a copy of your school or athletic physical. If you have questions, please call 812-855-2238.

Please complete the form below and submit camp payment.

 

Camper's Name (Last, First)*
 
Gender*
 Male
 Female
 
Parent/Guardian Name(s)*
 
Home Address*
 
City*
 
State*
 
Zip*
 
Camper's Home Phone #*
 
Parent's E-Mail Address*
 
Age*
 
Grade Entering (as of Sept. 2013)*
 
EMERGENCY NUMBERS  
Father's Home Phone #
 
Father's Cell Phone #
 
Father's Work Phone #
 
Mother's Home Phone #
 
Mother's Cell Phone #
 
Mother's Work Phone #
 
Name and phone number to call if parent/guardian(s) can't be reached*
 

MEDICAL CONSENT FORM
To enable the Health Center of Indiana University and/or other health facilities in Bloomington to provide prompt care to your son or daughter, we must have a completed Consent Form on file each year. This way, we can help your child without delay in an emergency.
 
Camper's Name (Last, First)*
 
Birthdate (Month/Day/Year)*
 
Insurance Company*
 
Policy Number/Group #*
 
Name of policy holder*
 
Social Security # (if used by insurance)
 
Allergic Reactions
 
Present Medication (include dosage)
 
Date of Last Tetanus Toxoid
 
Any past or present illness or other information that would be useful in the event that treatment is needed
 

* I grant permission to the Directors, Assistants, or other persons responsible for his care to act on my behalf for said minor in granting permission for evaluation and treatment of medical problems. I understand that should a major medical problem arise, an attempt will be made to notify me by telephone. In the event that I cannot be reached, I hereby give consent to such medical treatment as deemed necessary (including surgery, x-ray examinations and anesthesia to be rendered to said minor by a licensed physician or nurse.)  

* Waiver: I do hereby waive, release and discharge the Tom Crean Basketball Camps and the respective staffs, employees, successors, and assigns, of and from any and all rights and claims for damages resulting from injury of my person or property, which may be sustained or suffered by me in connection with my association with or participating in, or arising out of my traveling to or from Indiana Basketball Camp. We, the parents/guardians, agree to the above waiver and release and we join therein.  

Parent/Guardian Name*
 

PAYMENT OPTIONS
Please select your payment option by indicating a '1' in the quantity field. We need a registration form and consents completed for each participant.

Note: A charge from Hoosiersportscamps.com will appear on your credit card for your on-line registration. However, if the IU Basketball Camp is cancelled for any reason, refunds must be collected directly from the IU Basketball Camp, Phone 812-855-2238.
 
Qty 
 $150.00 Individual Camper - Payment in Full