RESIDENT CAMPER $385.00
*($100.00 Deposit)
DAY CAMPER-COMMUTER $275.00
*($100.00 Deposit)
WEEKEND CAMPER $300-00
*($100.00 Deposit)
*Non-Refundable Deposit

I hereby authorize any medical evaluation or treatment which may be advised or recommended by the attending physician of (student's name)
while at the Jim Calhoun Basketball Camp. WAIVER AND RELEASE AS REQUIRED BY THE JIM CALHOUN BASKETBALL CAMP FOR ALL CAMPERS: In consideration of my application being accepted, intending to be legally bound, do hereby, for myself, my heirs, executors and administrators, waive, release and forever discharge any and all claims for damages, which I may or which may hereafter occur to me, against The Jim Calhoun Basketball Camp and The University of Connecticut or their respective officers, agents, representatives, successors and/or assigns, for any or all damages which may be sustained or suffered by me in connection with my association with or participation in on the campus of The University of Connecticut. 1, the parent or guardian, do hereby agree to the above waiver and release.

Signature of Parent/Guardian________________________________________________________________________

Please send JIM CALHOUN BASKETBALL  CAMP literature to: (not your own name)

Name__________________________________________________________

Address________________________________________________________

City____________________________State___________/Zip________

Name of School __________________________________________________

HOME ADDRESS_____________________________________________________

CITY/STATE/ZIP_____________________________________________________

TELEPHONE (HOME) ____________________________________________________

TELEPHONE (WORK) Father's ____________________________________________________

TELEPHONE (WORK) Mother's ____________________________________________________

NAME OF SCHOOL_____________________________________________________

HEIGHT______ - WEIGHT _______- DATE OF BIRTH_____/______/_____

 I WOULD LIKE TO ROOM WITH__________________________________________________

(Campers are housed two to a room)

CHECK SESSION(S) WILL BE ATTENDING

___1 st Session SUN., JULY 11 -THURS., JULY 15

___2nd Session SUN., JULY 18-THURS., JULY 22

CANCELLATIONS: A refund of tuition, less a $100.00 administration fee, will be granted upon cancellation. Refunds will be granted only upon the receipt of a signed physician's excuse. All cancellations must be in writing as no cancellations will be taken over the phone. No refunds will be granted for ANY REASON after July 1, 1999. There will be no exceptions. No refunds will be granted for anyone who leaves camp before the session has ended. No substitutions will be accepted in the place of registered applicants.