Lu Dog Basketball Registration Form

Lu Dog Basketball Camp Registration Form

2010

For CHECK payment ONLY, type in your information, print out the form, and have a parent SIGN IT. Change your printer settings to print in landscape.

Name:

Age:

Grade:

Phone:

Address:
City:

State:

Zip:

Email: ** required for confirmation

School:
Date of Birth:

Team with my friend:

Emergency Contact:
Emergeny Phone:

T-Shirt Size: Adult S M L XL XXL Child L

I hereby authorize the staff of the Lu Dog Basketball Camp to act for me according to their best judgment in any emergency requiring medical attention for any injury or illness incurred while at the camp. I have no knowledge of physical impairment that would be affected by the above named camper's participation in the camp program as outlined in the brochure. I also understand that the camp retains the right to use for publicity and advertising purposes photographs of campers taken at camp.

Cost: $210.00 ($50 deposit)

For More Information Call:
(805) 493-3404

Parent or Guardian (please print full name)______________________________ Signature:____________________________

July 12-16 Day Camp July 19-23 Day Camp Aug. 2-6 Day Camp

Mail To:
Lu Dog Basketball Camps
California Lutheran University
60 W. Olsen Rd.
Thousand Oaks, CA 91360-2700

Make checks payable to:
LuDog Basketball Camps