Jeffersonville Lady Red Devils
SPRING/SUMMER CAMP 2015
This camp will focus on skill development and fundamentals under
the direction of varsity girls’ coach Michael Warren, staff, and
players.
DATES:
May 18-21(Grades 6-8)
JUNE 1-4(Grades 2-5)
TIME:
6 to 8 p.m. @ Jeffersonville HS
COST:
$40 per participant. Cost will be
adjusted for those unable to attend all
4 camp days due to schedule conflicts.
CONTACT:
Coach Michael Warren
[email protected]
(812) 282-6601 Ext. 15327
PLAYER REGISTRATION
Player’s Name: _____________________________________________________
Parent/Guardian Name(s): ___________________________________________
Address: __________________________________________________________
City: _________________________ State: ____ Zip: _______________________
Home Phone: ____________________ Cell Phone: ______________________
E-mail: __________________________ Age: _____ Birth date: ___ /___ /______
School: ____________________________ 2014-15 Grade: ____________________
Shirt size: (circle)
Youth S
Youth M
Youth L
Adult S
Adult M
Adult L
Adult XL
WAIVER AND RELEASE OF LIABILITY
My daughter has permission to attend and participate in the Jeffersonville Lady Red Devils
Basketball Camp. I have no knowledge of any physical impairment that would affect or be
affected by my daughter’s participation in this camp. I specifically waive and release the
Jeffersonville High School girls’ basketball coaching staff, the Greater Clark County School
Corporation and Jeffersonville High School of liability for any injuries that may occur as a
result of this camp.
X __________________________________
Parent’s/Guardian’s Signature
__________ ____________________
Date Signed Emergency Phone No(s).
Return completed registration form and payment.
Cash or Check Payable:
Mail Registration and Payment:
Jeffersonville Girls Basketball Camp
Jeffersonville High School
Attention: Coach Michael Warren
2315 Allison Lane
Jeffersonville, IN 47130