Thank you for registering with the Jim Calhoun Basketball Camp!
Mail
to: The Jim Calhoun Basketball Camp
c/o Gold, Orluk & Partners
P.O. Box 1177, Avon, CT 06001-1177
Please fill in completely. The form cannot be accepted without signatures.
Camper Name:
Address:
City:
State:
Zip:
Country:
Roommate
Requested:
Parent/Guardian Email (Required):
Home
Phone:
Parent/Guardian Cell Phone:
Parent/Guardian Work Phone:
Height:
Weight:
Birthday:
Type
of Camper: (Check One)
Commuter or Resident
Session
Requested: (Check One)
Session 1 (July 6th to July 10th) Session 2 (July 11th to July 15th)
CANCELLATIONS:
No refund will be granted for any reason after June 15th 2008. Partial refunds will be granted for only medical reasons with a signed physicians excuse. A $100 administrative fee will be deducted before any refund is made. All cancellations must be in writing, email or fax and will not be accepted over the phone.
_______________________________
(Parent/Guardian's Signature - only one)
I hereby authorize any medical
evaluation or treatment which may be advised or recommended by the attending
physician of _____________________________ while at the Jim Calhoun Basketball
Camp. WAIVER AND RELEASE AS REQUIRED BY THE JIM CALHOUN BASKETBALL
CAMP FOR ALL CAMPERS: In consideration of my application being accepted, intending to be legally bound, do hereby, for myself, my heirs, executors and administrators, waive, release and forever discharge any and all claims for damages, which I may or which may hereafter occur to me, against The Jim Calhoun Basketball Camp and The University of Connecticut or their respective officers, agents, representatives, successors and/or assigns, for any or all damages which may be sustained or suffered by me in connection with my association with or participation in on the campus of The University of Connecticut. I, the parent or guardian, do hereby agree to the above waiver and release.