Lady Viking Basketball &

Softball Camp 2017

June 5, 2017 - June 7, 2017

For Girls Entering
Grades 3-8
Cost: $50 each*
Basketball *$80 if registered in both
Session #1 9am-12pm Grades 3-5
Session #2 12:30pm-3:30pm Grades 6-8 Make Checks Payable to
Teays Valley High School
Softball
Session #1 9am-12pm Grades 6-8 Send to: Joel Baker or Brenna Giesige
3887 St Rt 752
Session #2 12:30pm-3:30pm Grades 3-5 Ashville, OH 43130
jbaker@tvsd.us
Players Name_____________________________________________Grade Entering this Fall ___

Parents Name_____________________________________________

Address___________________________________________________

City________________ Zip______________Home#:____________Cell#_____________

Parents Email_________________________________________________

Emergency Contact_____________________________________________
Phone Number_________________________________________________
Attending (Circle one):
Shirt Size: S M L XL Youth or Adult (circle one) Basketball - Softball
Both
Are there any medical conditions that the staff should be aware of?
*if attending both bring sack lunch


We/I give my permission for my daughter to participate in the Teays Valley Basketball/Softball Camp and agree that any medical

services needed are to be covered by our family medical coverage. In consideration for my daughters participation,

I will not hold the camp or its employees or Teays Valley Local Schools responsible for any loss, damages, or injuries that may be

received as a result in the participation in this camp. In addition, I give my permission for any medical treatment by

any qualified physician or at the nearest hospital emergency room in case that I cannot be reached.


Parent or Guardian Signature: ___________________________________ Date:___________

**All Campers receive a t-shirt