Name: Age (as of June 2008): Grade (1-12):
T-Shirt Size: XL L M S Youth L Youth M Youth S Gender Male Female
Height: Weight
Camper email
Parent email (if none, type none@coachlane.net)
Home Address
City State Zip
Parent's Name: Parent's Home Phone Parent's Work Phone
Emergency Contact Number
Please choose from the following sessions
Camp #1 Lane Shooting and Skill Development Camp Dates: June 16-18 Ages: Boys 8- 15 years
Session A- 9:00 am-noon ($70) Session B- Noon - 3:30 pm ($70) Session C- 9:00 am-3:30 pm ($130)
Camp # 2 Lane Basketball Day Camp Camp Dates: July 7-11 Ages: Boys and Girls age 7- 15 years
Session A- 9:00 am-noon ($95) Session B- Noon - 3:30 pm ($95) Session C- 9:00 am-3:30 pm ($190)
I hereby authorize the directors of the Lane Basketball Camps to act or me according to their best judgment in any emergency requiring medical attention and I hereby waive and release the camp from any and all liability for injuries incurred while at camp yes no {Name of Parent or Guardian}