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Girls Wheelchair Basketball
JU
The Alabama Girls Wheelchair Basketball Camp is for girls age 12-­‐19 with a strong emphasis on high-­‐
level wheelchair basketball performance. Campers planning to attend this camp should be independent, have a strong interest in competitive wheelchair Boys Wheelchair Basketball
basketball, and ready to participate in strenuous sessions up to 6 hours per day. Staff for this camp will include the Women’s Assistant Coach, Elisha Williams and players from the Women’s team. The Alabama Boys Wheelchair Basketball Camp is for boys age 12-­‐
19 and will focus on wheelchair basketball at a high level of competition. Campers attending the boy’s camp should be independent and ready to participate in strenuous instructional sessions up to 6 hours per day. The staff for the boy’s camp will include Men’s Head Coach Ford Burttram and players from the Men’s team. J ULY 9-12, 2015
Online Application forms can be found on our wheelchair basketball website: alabamaadapted.com Mail-In Application
Name: __________________________________ Address: _______________________________ __________________________________________ Home Phone: __________________________ Cell Phone: ____________________________ Email: __________________________________ Male or Female: _______________________ Nature of Disability: __________________ __________________________________________ Grade in School: _______________________ Age: ____________________________________ T-­‐Shirt Size: ___________________________ Years Experience: _____________________ Cost = $450.00 Amount Enclosed: ____________________ DEADLINE: MAY 31, 2015 Please cut along dashed line if mailing in application. Be sure to make a copy of camp dates and contacts before mailing in application. Waiver of Release and Publication
The law requires that parental permission be obtained for operative procedures on minors. The following consent form should be signed by parents so that no unnecessary delays will occur with operative procedures. However, no operation will be performed, except emergency, without parents being contacted and fully informed. I, as parent or legal guardian, have actual knowledge and appreciation of the particulars of the camp included those risks involved in participation in the wheelchair basketball cam, and hereby voluntarily consent to said minors participation and assume the risks arising there from. In consideration of my child’s/dependent’s participation in the University of Alabama’s Wheelchair Basketball Camp, I do hereby, for myself, my child/dependent, my heirs and executors, waive, release and forever discharge all rights an claims for damages and/or injuries for which I or my child/dependent may have, or which may hereafter occur to me and my child/dependent against Director Hardin and its employees and agents and the University of Alabama, for any and all injuries and/or damages which may be suffered by my child/dependent in connection with my child’s/dependent’s participation. Additionally, I hereby provide a grant of license and a release to use the name and photograph of my child as required to publicize the camp for a period of two years from the date of the release. I have read and understood the release and waiver of claims statement and fully agree with the provisions of this document. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT INDUCEMENT. Participant’s Signature: ______________________ Printed Name: ________________________________ Parent/Guardian’s Signature: __________________________________________________ Printed Name: _________________________________ Address: ________________________________________ __________________________________________________ City, State, Zip: _________________________________ Contact Number: ______________________________ Emergency Contact: ___________________________ Relation to Participant: _______________________ Mail application, signed waiver & fee to: Brent Hardin 1021 Moore Hall Box 870312 Tuscaloosa, AL 35487 University of Alabama Wheelchair Basketball Summer Camp JULY 9-­‐12, 2015 Travel plans should be made that campers can be on campus on Wednesday morning, July 9. The first teaching session for camp is Wednesday afternoon so flights should be made into Birmingham Airport to arrive no later than 11:00 AM shuttle on the 18th and depart no earlier than the 3:00 PM shuttle on Saturday, July 12. Cost for the University of Alabama Wheelchair Basketball boys and girls camp is $450 for all campers. These Fees include room, board, instructional costs, camp t-­‐shirts, and administrative costs. Make checks payable to University of Alabama Adapted Athletics. Housing for both camps will be in separate sections of the Riverside Dormitory Complex on the University of Alabama Campus. Rooms, restrooms, and shower facilities are all accessible. Packing lists will be sent about 2 weeks before camp starts with detailed instructions about what to bring and where to report. Questions should be directed to the Camp Director, Brent Hardin: 205-­‐348-­‐5109 [email protected] ABC Camp Scholarship to be considered for an ABC Camp scholarship, please email Brent Hardin ([email protected]) or send a 1-­‐2 page letter with the application giving a summary about yourself, including why you would like a scholarship. Women’s Basketball National Champions 2009, 2010, 2011, 2015 Men’s Basketball National Champions 2013 ALABAMA ADAPTED ATHLETICS Brent Hardin, Director [email protected] Elisha Williams, Women’s Basketball [email protected] Ford Burttram, Men’s Basketball [email protected] AlabamaAdapted.com