Danny Kaspar's Basketball Camp
at Stephen F. Austin State University
Registration Form
APPLICATION MUST BE FULLY COMPLETED, SIGNED, AND DATED TO BE ENROLLED 

Please print this form and send a 
completed copy with tuition to: 
Danny Kaspar                      Camp Type A) Resident      ($310) _________________
P.O. Box 633013                             B) Non-Resident  ($245) _________________
Nacogdoches, TX 75963-3013                  C) Day Camp      ($180) _________________

                                    Payment    Amount:__________  Check #:_________ 

Add a $15 late registration fee if postmarked after June 2, 2008.
Add a $25 late registration fee if postmarked after June 9, 2008.


Name________________________________________________  Age________ 


Birthdate_______/________/________Grade (Fall 2008)______________


Address___________________________________________________________


City_____________________________State_______ZIP_______________________


Home Phone (____)_______________________________________


Parent’s Business Phone(_____)__________________________________________

E-mail address:___________________________________________

T-Shirt size (circle one) ADULT size:   XS     S     M     L     XL     XXL 


Parent or guardian’s signature_________________________________________________________ Date____________________
                              I have read and agree with the cancellation policy stated in this brochure.
MEDICAL WAIVER
I (parent) _________________________________________ agree that (participant) ________________________________________________________________________ may participate in The Danny Kaspar Basketball Camp at Stephen F. Austin State University. In consideration of participation in this event, I agree, on behalf of the above named child, his/her heirs and representative to fully and forever release, and hold harmless The Danny Kaspar Basketball Camp, its agents, servants, and employees from any and all claims, demands, damages, rights of action of causes of action, present or future, whether the same be known, anticipated or unanticipated, resulting from or arising out of participation in this event. I HEREBY AUTHORIZE IN ADVANCE ANY NECESSARY MEDICAL TREATMENT REQUIRED BY THE ABOVE NAMED CHILD WHILE IN ATTENDANCE OF THIS CAMP. I ALSO ACKNOWLEDGE THAT I HAVE/WILL NOTIFY THE CAMP PERSONNEL OF ANY SPECIAL MEDICAL NEEDS OR INFORMATION REQUIRED BY THE ABOVE NAMED CHILD. Also, I understand that all rules and regulations for the camp/event will be enforced and any violation by my child could result in a call to me with possible request to pick up my child with no refunds being given. This camp is owned and operated by Danny Kaspar. 
Signature of Parent or Guardian _____________________________________  Date_______________________


Emergency Contact Number___________________________ Health Insurance Policy_______________________


Name:___________________________________________ Policy Number____________________________________


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