Medical Release Form For Players currently in Grades 3-8 I certify that ___________________ is physically fit for playing basketball. FUNdamentals First Camp Hours 9:00 am-3:00 pm Insurance and Medical Information (this section is required) Name of Insured ___________________ Camp Location Godwin High School Policy Number ____________________ 2101 Pump Road, Henrico VA 23238 Doctor’s Name ____________________ Doctor’s Phone ____________________ Camp Features Medications camper is currently taking: _______________________________ Medical conditions currently being treated: _______________________________ List any allergies, special conditions, or special needs: _______________________________ _______________________________ Emergency Contact Name and Number: _______________________________ In the event my daughter suffers any accident requiring medical treatment, I hereby give permission for any medical treatment which may be deemed necessary and reasonable under the circumstances. Additionally I give permission for video and/ or photos to be taken to be used for promotional use. _______________________________ Parent/Guardian Signature and Date Free Camp T-Shirt for all campers Camp Concessions with snacks and drinks available Lunches can be brought from home or purchased at camp concessions Camp Prizes will be awarded for 3 on 3 Tournament Hot Shots Contests Ball Handling Free Throw Contest 5 to 1 Camper to Coach Ratio Age-Specific Instruction Sibling Discount—10% discount for each additional child Godwin Lady Eagles Girls’ Basketball Camp June 22-25, 2015 9am—3pm Who We Are The camp will be led by Lady Eagle Head Coach, Trevor Lampman, along with current college players, Godwin Girls’ Basketball Staff, and current Godwin Lady Eagle players. What We Do We will provide an opportunity for young basketball players, currently in grades 3-8, to learn drills, techniques and fundamentals that coaches utilize at every level. The activities and drills will be age and/or skill-level specific and will equip your daughter to advance her game and take it to the next level. About Coach Lampman Typical Camp Schedule 8:45 am Campers Register/ Sign In 9:00 am Free shooting 9:15 am Warm Ups / Stretching 9::50 am Stations (passing, defense, ball handling and shooting) 10:50 am Morning Break 11:00 am Camp Games 11:30 am Mass Session (ex. screening) 11;45 am 3 on 3 Practice w/ counselor Noon Lunch 1:00 pm Warm Ups 2015 Godwin Lady Eagles Girls’ Basketball Camp Application For Players currently in Grades 3-8 Name of Camper_______________________ Address_____________________________ ___________________________________ Parent/Guardian Name ___________________________________ Phone ______________________________ Email_______________________________ Camper’s Age_________________________ Entering Grade (next year)________________ Head Girls’ Basketball Coach at Godwin HS Ten Years Division I Coaching Experience Eight Years Varsity Coaching Experience Has coached numerous Collegiate Division I All-Conference athletes who went on to play professional basketball 1:10 pm Position Work (guards, posts) Youth Small Youth Med Youth Large 1:30 pm Individual Contests/ Games Adult Small Has coached several High School All-District basketball players, including a McDonald’s All-American 2:00 pm 3 on 3 Games 3:00 pm Campers get picked up Every athlete will be challenged and will come away a better player!!! School______________________________ Shirt Size (circle one) Youth XL Adult Med Adult Large Adult XL Camp Payment Sign Up before May 18 $110 ($50 deposit required and balance due on June 22) Sign Up after May 18 $135 ($50 deposit required and balance due on June 22) Fill out both sides and send to: Godwin Lady Eagles Basketball Camp 2101 Pump Road, Henrico VA 23238 804-750-2600 Email - [email protected] Make checks payable to Godwin High School
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