Mike Hubka Lowell Dohrmann

Principal Activities Director

May 18, 2008

2008 GIRLS BASKETBALL CAMP

Dear Parents and Campers;

We are proud to announce our Girls Basketball Camps this summer at Medicine Lodge High School. The goals of our camp are to provide each camper with an enjoyable and rewarding experience with the great game of basketball. We are interested in basketball and would like Medicine Lodge campers to improve her skills in the game of basketball.

We are looking forward to having your daughter be a part of this year's basketball camp.

Cost: $30 per camper.

Date & time: June 16^th - June 19^th.

Grade for next year.

4-6 11am-12:00noon

7-8 9:30am-10:45am

9-12 8am-9:15am

Where to report:

Campers should report to the registration desk in the main hall of Medicine Lodge High School 15 min. before camp time.

Pre-registration by June 11^th.

Lowell Dohrmann

Melissa Hrencher

Girls Basketball Coaches

Medicine Lodge High School

2008 GIRLS BASKETBALL CAMP

CAMPER’S NAME: ________________________

HOME PHONE # ________________ CELL #_____________________

ADDRESS:___________________________ CITY:_______________________ STATE: ______ ZIP:__________

Fathers name __________________work or cell number__________

Mothers name _________________work or cell number__________

For the protection of your daughter in case of an injury while participating in the summer basketball camp, YOU MUST FILL OUT AND SIGN THE FOLLOWING STATEMENTS. This is only if we cannot contact a parent/guardian.

________________________________________________________________________

I give Coach Lowell Dohrmann / Melissa Hrencher permission to seek medical treatment for my child, _______________________________ While participating in the summer basketball camp.

Insurance Co. Name and Address_________________________

_________________________

Insurance Number and Group No. ________________________

Parent(s) Signature ________________________________

Date ______________

________________________________________________________________________

If no insurance is owned, I waive all rights and claims against Coach Dohrmann & Coach Hrencher in case of an injury ordinarily covered by insurance.

Parents Signature _____________________________

Date _______________

________________________________________________________________________

PLEASE CIRCLE AGE GROUP

4-6 7-8 9-12

SHIRT SIZE : Return to:

Lowell Dohrmann

Youth small_______ Adult small______ Girls Head Coach

Youth Medium____ Adult Med _______ Medicine Lodge High School

Youth Large ______ Adult Large ______ 400 W. Eldorado

Adult XL _______ Medicine Lodge, Ks 67104

Make checks payable to: Lowell Dohrmann