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Registration Form

Make checks payable to: Robert F. McCormack, Inc.

Mail to: 1071 Purcell Ave. St. Louis, MO. 63130

For more information, call 314-985-6100 ext.2106

 

Bob McCormack – Summer Basketball Camps – 2011

 

Name: __________________________________________________________

 

Age  ______________ Height ________ Weight _____________

 

Address: ________________________________________________________________

City/State/ZIP

 

______________________________________Phone:_____________________

 Emergency Contact/Phone: ________________________________________________________________

 

Grade (2011 School Year)  _________  T-Shirt Size (adult) _____________

 

School/Team______________________________________________________

 

E-Mail address: _________________________________________________________________

 

CAMPS: (Please circle appropriate camp): For Ages 7 -14

 

• May 31-June 3 AM or PM ($120)          • June 6-10  ($225)       • June 13-17 ($225)    

• June 20-24 ($225)      • June 27-July 1 ($225)           • July 5-8 ($200)

  • July 11-15 ($225)  • St. Louis Basketball Academy July 18-22 ($225)

 

A $50 NON-REFUNDABLE processing fee is charged for a cancelled reservation

I hereby request that my child be admitted to the Bob McCormack Basketball Camp. I hereby authorize and direct the Basketball Camp staff to exercise and act in their best judgment in the event any medical emergency regarding my child may arise. I also hereby confirm that my child is covered by accident insurance which provides coverage for any accidental bodily injury. By my signature below, I hereby agree to hold harmless Bob McCormack, Robert F. McCormack Inc. and any of its agents and/or employees in connection with any incident or occurrence arising out of my child’s enrollment in the Basketball Camp. Payment in full is required at time of registration to reserve your child's position.

 

 

 

PARENT/GUARDIAN SIGNATURE  (required)

______________________________________________________

Print Name: ____________________________________________

 

 

Make checks payable to: Robert F. McCormack, Inc.

Mail to: 1071 Purcell Ave. St. Louis, MO. 63130