Central States Women’s
Basketball Officiating Camp
May 30 – 31, 2015 ◊ Olathe, KS
This camp is an instructional camp targeted at current and potential
women's college basketball officials. Focus of the camp will be on teaching
the principles of officiating 3-man, proper 3-man mechanics, and
philosophies of officiating. The staff is committed to making all officials
better officials during the course of the camp.
WHAT YOU WILL GET
DIRECTOR’S RESUME
 On court instruction and game
by game evaluations from an
experienced staff.
 Staff will be current Division 1
NCAA officials as well as select
HAAC and college officials.
 Camp provides valuable
experience and feedback for
high school and college
officials.
 Extensive 3 man mechanics
lessons.
 Elite USJN girl’s high school
competition.
 Video evaluations will also be
conducted with video available
to be watched on site.
Camp Director will be David
Brown. He has just
completed his seventh year
as Supervisor of Women's
Officials for the Heart of
American Conference, a
Division 1 NAIA conference.
David had 18 years of
experience in the HAAC, 17
years of experience in the
NCAA Division II MIAA and 5
years of experience in the
MVC prior to accepting the
supervisor's position for the
HAAC.
REGISTRATION
PERSONAL INFORMATION
NAME________________________
ADDRESS____________________
_____________________________
CITY ________________________
STATE __________ ZIP ________
PHONE NUMBERS:
HOME ______________________
WORK_______________________
CELL ______________________
TEXT CAPABLE  Y  N
SERVICE PROVIDER: __________
E-MAIL______________________
DOB _________
GENDER M  F
CAMP FEES
$135 for all officials
Please make checks payable to:
Central States Women's Basketball Officiating
Camps
6740 NE Main
Pattonsburg, MO 64670
SHIRT SIZE
 S  M  L  XL  XXL
 YES
OFFICIATING EXPERIENCE
NEW OFFICIAL
TOTAL YEARS OFFICIATING __________
YEARS WORKING H.S.
__________
YEARS WORKING COLLEGE __________
Please list all high school and college
conferences you have officiated in and
supervisor below:
_____________________________________
_____________________________________
_____________________________________
_____________________________________
_____________________________________
WAIVER
I, ___________________________
do hereby waive the Central States Women’s
Basketball Officiating Camp, camp staff and
personnel, and host facilities from liability due
to injury or loss of property. I am attending this
camp voluntarily and take full responsibility for
myself and possessions while in attendance at
the City of Olathe or Gardner.
PAYMENT IS NOT
REFUNDABLE AFTER
MAY 17, 2015
 NO
Registration deadline for the May camp is May 17, 2015.
Registration for both camps will be limited. Advanced
registration is encouraged.