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Basketball Prospect Camp

(*) denotes required information.

Payment in full, $100, is required to be received by the camp office in order to reserve a spot in the camp.
 
* First Name:
* Last Name:
* Address:
* City:
* State:
* Zip:
* Phone:
* Email:
* Date of Birth:
* Grade in 2013-14 School Year:
* Position:
* Shirt size:
 
Insurance Information:  
* Insurance Company:
* Policy Number:
* Phone:
 
Please list any medications/medical conditions:
 
Medical Consent:  
In the event of emergency, please list two people we can contact.
 
* Primary Contact:
* Relationship to Camper:
* Phone:
Secondary Contact:
Relationship to Camper:
Phone:
 
In signing this application I release Gettysburg College and other involved parties from any claims or responsibility for injuries suffered in the camp. I knowingly assume all risks associated with participation and assume full responsibility for my participation. I certify that the camper is in good physical condition and can participate in the Gettysburg College Prospect Camp. Further, I authorize the site director to request medical treatment as necessary to ensure well-being.
 
* Signature:
* Date:
 
 
 
Gettysburg College 300 North Washington Street · Gettysburg, PA 17325
P: 717.337.6300