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INDIANA GIRLS BASKETBALL CAMPS

June 13-16, Bloomington, Indiana
Cook Hall at Indiana University

CAMP COSTS

$275.00

CAMP DETAILS

- Open to Girls Grades 3-8

- Registration - June 13, 8-9 a.m. Cook Hall

- Lunch included each day 

- Free T-Shirt

-  Camp runs 9 a.m. - 4 p.m. each day

 

All camps open to all and any entrants

FOR REGISTRATION INFORMATION/INQUIRIES:

- E-Mail: For Further Information!
- Register On-Line: Now Available!




2017 Fundamental Camp

Registration is Closed for this Camp

 
Registration Note: All cancellations and/or request for refunds must be received two weeks prior to the camp start date.If the cancellation notice is received before the above-said deadline, full payment will be returned except a $75 administrative fee.The administrative fee is not refundable for any reason.If the cancellation notice is received after the above-said deadline, no refunds will be given unless there is a medical circumstance in which proper documentation is required.Teri Moren Basketball Camps LLC reserves the right to change and/or cancel any camp at any time in which a full refund will be honored.No refunds/Discounts for late arrivals or no shows.
 
Camper's Name (Last, First)*
 
Home Address*
 
City*
 
State*
 
Zip*
 
Parent/Guardian Name(s)*
 
Camper's Home Phone #*
 
Parent's Cell Phone #*
 
Parent's E-Mail Address*
 
Age*
 
HS Graduation Year (i.e. 2022)*
 
T-Shirt Size*
 Y-S
 Y-M
 Y-L
 S
 M
 L
 XL
 XXL
 
Camper's School*
 
Coach's Name
 

MEDICAL CONSENT FORM
In order to enable the Health Center of Indiana University and/or other health facilities in Bloomington to provide prompt care to your minor daughter,we must have a new completed Medical Consent Form on file each year.This way,we can help your child in an emergency without delay.
 
Name of Minor*
 
Birthdate (Month/Day/Year)*
 
Insurance Company*
 
Policy Number/Group #*
 
Name of Policy Holder*
 
Allergic Reactions
 
Present Medication (include dosage)
 
Date of Last Tetanus Toxoid
 
Any past illness, injury or other information that would be useful in the event of medical treatment
 

EMERGENCY NUMBERS
 
Mother's Home Phone #
 
Mother's Cell Phone #
 
Mother's Work Phone #
 
Father's Home Phone #
 
Father's Cell Phone #
 
Father's Work Phone #
 
Name and Phone Number to call if parents cannot be reached*
 

* I grant permission to the Directors, Assistants, or other persons responsible for her 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 Teri Moren Basketball Camps, I, for myself, my heirs, personal representatives or assigns, do hereby release, waive, discharge and covenant not to sue Teri Moren Basketball Camps LLC and Forward Marketing LLC, their officers, employees and agents for liability from any and all claims including the negligence of the Teri Moren Basketball Camps, 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 Teri Moren Basketball Camps.  

* By my submission of this registration, I represent that I am either 18 years of age or older, or that I am the parent or legal guardian of the registrant (if he/she is under age 18). I represent I have read the terms of the Privacy Policy, that I understand the manner in which the information collected about the registrant may be used, and that I agree to the use of the registrant’s personally identifiable information in the manner described in the Privacy Policy.  

Parent/Guardian Name*
 
Date*
 

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 Teri Moren Basketball Camps are canceled for any reason, refunds must be collected directly from Teri Moren Basketball Camps LLC, 3400 South Sare Road #112, Bloomington, Indiana 47401.
 
Qty 
 $275.00 Individual Registration - Payment in Full