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Athletics
Boys Summer Basketball Camp Registration Form  

2010 South Jefferson Boys Summer Camp
Registration Application

Fill out Form (type in info) and print
Name:     (last name, first name)
Street Address:
City:   State:   zip code:
Home Phone:   
Emergency contact during the day:     phone:
Registration on the opening day of camp will owe an additional $10.00
Grade Fall 2010: 
Age Date Of Birth:
T- shirt size: S M L XL

 
Send application and money to:
Coach Fred Piche
Box 226
Adams Center, NY 13606

Make checks payable to:
 
South Jeff Varsity Club
 

Camp cost is $75.00 per athlete, which includes a t-shirt at the end of camp.
Registration on opening day of camp will owe an additional $10.00

 









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