EmailMe Form - Basketball Camp 2015

NORTHLAKE CHRISTIAN SCHOOL SUMMER BASKETBALL CAMP 2015

Camper's Name *

First Last

Camper's Age *

Grade entering Fall 2011 *

Birthdate *

MM / DD / YYYY

Home Address

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

Current School

Parent #1 Name *

First Last

Parent #1 Daytime Phone: *

### - ### - ####

Parent Email: *

Parent #2 Name:

First Last

Parent #2 Daytime Phone:

### - ### - ####

T-Shirt Size:

Session Choice: *

Session #1 - June 22-26

Session #2 - July 13-17

To Pre-Register, please send check payable to NCS with "Basketball Camp" in the memo.

You may print out the confirmation that you receive and send it to:

NCS Attn: Tony Agresta
70104 Wolverine Drive
Covington, LA 70433

Medical Release Forms to be filled out at Registration.

Camp Fee: $175 (Includes lunch and ball)

For further information, please email aagresta@northlakechristian.org

Before Care (7:00-8:30) $25/week or $5/day and After Care (3:00-5:30) $25/week or $5/day is available through CAMP NORTHLAKE.

(must note Before/After care on registration form and separate check or cash must be paid directly to Camp Northlake to utilize Before/After Care.)

I will need Camp Northlake

Before Care

After Care

Both

NORTHLAKE CHRISTIAN SCHOOL SUMMER BASKETBALL CAMP 2015

To Pre-Register, please send check payable to NCS with "Basketball Camp" in the memo. You may print out the confirmation that you receive and send it to: NCS Attn: Tony Agresta 70104 Wolverine Drive Covington, LA 70433

Before Care (7:00-8:30) $25/week or $5/day and After Care (3:00-5:30) $25/week or $5/day is available through CAMP NORTHLAKE.

To Pre-Register, please send check payable to NCS with "Basketball Camp" in the memo.

You may print out the confirmation that you receive and send it to:

NCS Attn: Tony Agresta
70104 Wolverine Drive
Covington, LA 70433