GC Elite & Showcase Camps

Name*

First Last

Phone*

Email*

Home Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

T-shirt size

Position & Height

Playing Experience

High School*

Graduation Year

Interested areas of study

High School Coach's Name*

First Last

High School Coach's Phone

AAU Club Team

Club Team Coach's Name

First Last

Club Team Coach's Phone

Parent/Guardian and Emergency Contact

Parent/Guardian Name*

First Last

Parent/Guardian Email*

Parent/Guardian Phone*

Emergency Contact Name*

First Last

Emergency Contact Phone*

Liability release*

Yes
No

I believe the information provided above is a complete and accurate statement of the physical and behavioral factors which may affect my child’s participation in this summer camp sponsored by Goshen College. I hereby grant permission for my child to take part in this Summer Camp sponsored by Goshen College. I also agree, on behalf of myself or my child, not to make any claims of any kind against Goshen College or any of its employees or agents for any loss or injury that my child might sustain while engaged in the Summer Camp program. I authorize such physician or medical staff as Goshen College may designate to carry out any minor treatment and/or medical staff to provide any treatment deemed necessary for the well-being of my child.

Photo release*

Yes
No

I hereby grant permission to Goshen College, and its employees, agents, and assignees, the right to photograph my child or use their picture for purposes of advertising, publicity, trade, or otherwise, as still photographs, transparencies, motion pictures, television, web images, or other media or means of reproduction, transmission, or exhibition. I release Goshen College, its employees, agents, associates, successors, and assignees from any and all claims for damages or compensation for any claims based on the use or sale of said materials. I hereby waive the right to inspect, approve, or edit said material.

Basketball Camps

Which camps will you be attending?*

GCWBB Elite Camp (Incoming Jr & Sr players) - July 30
GCWBB Showcase Camp (Incoming Frosh & Soph players) - Aug 13

Would you like to do a Campus Tour?*

Yes, I would like to do a campus tour.
No, I would not like to do a campus tour.

Women's Elite Basketball Camp (Incoming Jr & Sr players) - July 30*

Price: $55.00

Women's Showcase Camp (Incoming Frosh & Soph players) - Aug 13*

Price: $55.00

Pre Registration Active?

Yes
No

How would you like to pay?*

Credit Card (pay now)
Check (at a later date)

Pre-Registration Discount

Price: -$10.00

Now until July 31 for ELITE Camp.
Now until August 14 for Showcase Camp.

Please make a check out to Goshen College Women's Basketball and mail to:

Stephanie Miller
Goshen College
1700 S. Main St.
Goshen, IN 46526

Total

$0.00

Payment Information

Billing Address*

Same as Home Address?

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Total

$0.00

Name

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GC Elite & Showcase Camps

GC Women’s Basketball ELITE Camp

GC Women’s Basketball Showcase Camp

Location

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Registration

Playing Experience

Parent/Guardian and Emergency Contact

Basketball Camps

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