NU Skills & Drills Camp Application (Print and Mail to address below)

Name____________________________________________      Home Phone______________________
Parents Name Mother______________________________Father_____________________________
Other_______________________________________
Address____________________________________ City____________  State_____ Zip___________
Email____________________________________ Grade_____________ Age____________

Emergency Contact/Phone #____________________________________________________________

I hereby authorize the Directors to act for me according to their best judgment in any emergency situation.

Parent/Guardian Signature____________________________________________________________


No Confirmation will be sent!  May call to confirm if needed.

You will be notified if there is a schedule change

Make checks payable to:  RISE Basketball Camp
Mail to:                 Paul Booth, Basketball Coach
                                                Norwich University
                                                158 Harmon Drive
                                                Northfield, VT  05663