CHANEY - HILL

BASKETBALL CAMP

1998 APPLICATION

Session: July l9-23 - July 26-30

TUITION:$385-00 Per Week (Incl.rm., board) $50.00 min. deposit for each one-week session due with application

(Please Print or Type) Female- Male-

Camper's Name

Address

City

State_______Zip____

_____

Day # Night

Age- Roommate Request:

(for request to be granted, each camper must request the other as a roommate)

429 South 50- Street, Philadelphia, Pa 19143

A deposit of $ is enclosed for

registration. Deposit is refundable only if

camper is not accepted. Balance due for the

first session July 13;

for second session by July 20.

1 understand that should

(camper's name)

be dismissed from camp for failure to abide by

the rules and regulations or for any conduct no

considered to be in the best interest of the

camp, no part of the tuition will be refunded.

Parent or Guardian's Signature:

X______

________