Highlander Summer Basketball Camp

If you have any questions, please call or email. Phone: 542-8505 E-mail: rgianfagna@nafcs.k12.in.us

Cost: $50.00

Make checks to NAFCS Schools

All Campers will receive a T-shirt and Basketball.

Name:______________________

Grade (next year’s grade)________

Address:____________________________________________________________________________

School: ____________________

Home Phone: _______________

Cell Phone:__________________

T-Shirt Size: Circle One

Youth: M(10-12) L(14-16)

Adult: S M L XL

Emergency Contact Name: ____________________________

Emergency Phone Number: ____________________________

Please mail form to:

ATTN: Coach Gianfagna

Floyd Central High School

6575 Old Vincennes Road

Floyds Knobs, IN. 47119

Players will get instruction on the following areas: correct shooting form, ball handling techniques as in dribbling the ball with finger tips and eyes on the rim, defensive positioning in between the player’s man and basket, rebounding, and team play.

Medical Release

I approve of my child being at the Floyd Central Basketball Camp, and I certify that he is in good health and able to participate in program activities. I authorize the Directors at the camp to act for me according to their judgment in an emergency requiring medical attention, including treatment by physicians. By signing below, I hereby assume any and all risks which are incumbent with any excursion of the program and extracurricular activities in which my child might participate, with realization that these activities may subject him to personal bodily injury or property damage risks. I am aware that certain damages may occur with other individuals and/ or athletic equipment facilities which may result in cuts, abrasions, sprains, bruises, strains, concussions, and fractures or even death. Being fully aware of these dangers, I nevertheless voluntarily choose to allow my child to participate in the Floyd Central Basketball Camp, and I assume all risks arising thereafter. I do hereby release, acquit, and forever discharge the State of Indiana, The County of Floyd, Floyd Central High School, the camp directors and employees/ volunteers, and all other persons and/ or agents of Floyd Central High School who plan or direct in the aforementioned program and from actions, account of any and all injury, directly or indirectly sustained by my child as a consequence of his participation in the above mentioned athletic camp. I will be responsible for any medical or other charges in connection with his attendance at camp.

Parent/ Guardian Name:

____________________________________

Address:

____________________________________

We would like to thank the following camp sponsors:

Gary Longest Construction Co., Inc. (4 years)

Schuler Homes (3 years)

Beef’O’Brady’s (2 years)

Jones Jones Automotive Outlet (3 years)

Isenberg Spray Foam Insulation (2 years)

First Harrison Bank (1 year)

Active Ankle (1 year)

John M. Conner, M.D. (1 year)

Bearno’s (1 year)