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2014 RANDY BLOEMENDAAL BOYS TENNIS CAMP

CAMP COSTS*

$695.00 Overnight/
$575.00 Extended Day


*
NEW! $50 "team" discount available if six or more overnight campers register from the same high school team. Team members will also receive one extra private session along with high school coach! 
* 10% discount given to overnight campers that register by March 1, 2013
* 10% discount for children of full-time IU employees for the Overnight Camp

Please note on discounts - only one of the discounts can be applied per registration. All discounts available to any and all registrants.

CHECK-IN/CHECKOUT

Campers will check-in between 3-4 p.m. on Sunday, June 23.


FOR REGISTRATION INFORMATION:

Phone: 1-812-855-1006
E-Mail: Click Here!
Register On-Line: Now Available!

TO CONTACT COACH BLOEMENDAAL:

Phone: 1-812-855-1006
E-Mail: Coach Bloemendaal
Mail Questions To:
Randy Bloemendaal
Hoosier Boys Tennis Camp
Athletic Dept., Indiana University
1001 East 17th Street
Bloomington, IN 47408

CAMP CHECKLIST

Click Here for a list of recommended items to bring to camp and for directions


All IU Camps are open to all and any entrants

2013 Overnight Camp

Registration Note: All campers who cancel, including those for medical reasons, will be refunded all pre-paid fees, minus a $75 handling fee, provided they cancel before May 30, 2013. No refunds are given with less than two weeks notice before the start of camp for any reason.

Please complete the form below and submit camp payment.

 
Camper Options (select one)*
 Overnight Camper
 Extended Day Camper
 
Camper's Name (Last, First)*
 
Home Address*
 
City*
 
State*
 
Zip*
 
Parent/Guardian Name(s)*
 
Parent's E-Mail Address*
 
Home Phone #*
 
Father's Cell Phone #
 
Mother's Cell Phone #
 
Camper's School
 
Grade Entering (as of Sept. 2013)*
 
Age*
 
Are you a past IU Tennis camper?*
 Yes
 No
 
Roommate Preference
 
*Note: Roommate preference must be declared in advance!
 
How did you hear about IU Tennis Camp?
 Past Camper
 IUHoosiers.com
 Internet Search
 Camp Brochure/Mailer
 Other
 
Other
 
Which (if any) discount will you be applying?*
 None
 Early Bird Discount (before April 1, 2014)
 IU Discount (valid IU e-mail address required for parent)
 Team Discount/Extra Session (minimum of six teammates)
 
Skill Level (Select One - NOTE: This self-rating is simply for information purposes. Coach Bloemendaal will evaluate players on the opening night of camp and then place players into appropriate groups)*
 Beginner
 Intermediate
 Jr. Varsity
 Varsity
 USTA Tournament Player
 
T-Shirt Size (adult sizes)*
 S
 M
 L
 XL
 XXL
 

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, we must have a completed Consent Form on file each year. This way, we can help your child without delay in an emergency.
 
Name of Minor*
 
Medical Insurance Company*
 
Policy Number/Group #*
 
Insurance Company Phone
 
Name of policy holder
 
Drug Reactions
 
Present Medication (include dosage)
 
If the camper should be restricted from any activity, please note
 
Date of Last Tetanus Toxoid
 
Any Past Illness or other information that would be useful in the event of medical treatment
 
Name and Phone Number to call if parents cannot be reached
 
Hay Fever*
 Yes
 No
 
Asthma*
 Yes
 No
 
Eczema*
 Yes
 No
 
Insect Stings*
 Yes
 No
 
Other
 

* I grant permission to the Directors, Assistants, or other persons responsible for his care to act on my behalf of 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: In consideration of being allowed to participate in the Hoosier Boys Tennis Camp, I, for myself, my heirs, personal representatives or assigns, do herby release, waive, discharge and covenant not to sue Hoosier Boys Tennis Camp, Forward Marketing LLC, its officers, employees and agents for liability from any and all claims including the negligence of the IU Boys Tennis Camp, Forward Marketing LLC, its officers, employees and agents, resulting in personal injury, accidents or illnesses (including death), and property loss arising from, but not limited to, participation in the Hoosier Boys Tennis Camp.  

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 any of the IU Boys Tennis Camps are canceled for any reason, refunds must be collected directly from IU Boy's Tennis Camps, 1001 E. 17th St., Bloomington, IN 47408. Phone 812-855-1006.

 
Qty 
 $250.00 Option 1 - Overnight Camper Deposit

 $695.00 Option 2 - Overnight Camper - Payment in Full

 $625.00 Option 3 - Overnight Camper IU Employee Discount - Payment in Full

 $645.00 Option 4 - Overnight Camper Team Discount - Payment in Full

 $575.00 Option 5 - Extended Day Camper - Payment in Full