Name______________________________ e-mail ___________________________________

Address_____________________________________________________________________

Cell Phone_________________________ School ___________________________ Age_____

_____ SHOOTING WORKOUT Sunday Feb. 12 ($35) 12:30 - 2

_____ 3 ON 3 February 26, March 4, 11, 18, 25, April 1 ($80 before Feb 15)
(Game times between 6 - 9pm will be assigned by Feb. 23)

SUMMER CAMP $245 ($230 if received before April 1)
_____ June 25 – 29
_____ July 16 – 20

_____ July 30 – Aug. 3
_____ Aug. 13 - 16 Girls MS Camp

Make checks payable to Bob Foley
Mail all applications to: 11308 Deephaven Ct ; Richmond , Va. 2323
3

WALK IN FEE: There is a $5 fee for all 1 day clinics and $10 fee for all multiple day clinic, camps and leagues.
Please call 387-9493 in advance to check if space is available.

Assumption of Liability
I understand that this program carries the possibility of physical injury and may involve physical activity that may be strenuous and that there are risks inherent in this recreational activity. I further understand that Next Level Basketball and its officers and agents are not liable for any injuries that may result from the negligence of persons conducting this program. It isrecommended that participants secure adequate medical insurance to cover any injuries that may arise from participation in Next Level Basketball's programs.

Pease list any allergies, special conditions, or special needs ________________________________________________

Parent Signature_____________________________ Work /Cell phone ____________________________


 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .