The M.A.C.

Ty McGregor’s

Summer Roundball Camp

Registration Form

Print Camper’s Full Name: __________________________________   (Circle One)  Gender:  M  /  F

Grade Going Into: ______   Adult T-Shirt Size:  S  M  L  XL   (Circle Size)

Address: ___________________________________   City/State/Zip:______________________

Phone: (       ) ______-_________    Camp Session Attending:   1   2   3   4    (Circle Session)

Skill Level From 1 to 10 (1 = beginner – 10 = skillful): ______

Parent/guardian authorization: I hereby certify that my child is in good health and able to participate in basketball camp activities.  I also hereby authorize the coaches/employees of the camp to act for me according to their best judgment.  I hereby release this basketball camp from any and all actions for any injuries sustained while at the basketball camp or in the process of being transported to and from the basketball camp. 

Parent/Guardian Signature: _____________________________________________  Date: _____________

Send Registration Form To:

Ty McGregor's Roundball Camp

1687 Mishler Rd.

Luzerne, MI 48636