Summer Camps/Clinics Basketball Registration - Missouri State University

Email address *

I am requesting registration for the following Clinic/Camp:

Grizzly Basketball Camp - MORNING Session Only - June 19-21, 9:00a-12:00p ($95 if reg by June 19, $110 if registering day of camp) Grizzly Basketball Camp - AFTERNOON Session Only - June 19-21, 12:30p-3:30p ($95 if reg by June 19, $110 if registering day of camp) Grizzly Basketball Camp - ALL DAY Camp - June 19-21, 9:00a-3:30p - Camper must bring their own lunch ($175 if reg by June 19, $190 if registering day of camp) Grizzly Basketball Camp - ALL DAY Elite Camp - June 22-23, 9:00a-2:00p - Camper must bring their own lunch ($140 if reg by June 21, $175 if registering day of camp)(Only for Grades 7th-12th)

Camper's Name *

Parent/Guardian

Address

City

State

Zip

Parent Cell Phone *

Camper's Grade (Fall of 2023)

Camper's School

Coach's Name

Camper Shirt Size *

Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult XL Adult XXL

We/I, hereby request that you accept the application of the named individual above on this form in the 2023 Missouri State University-West Plains Grizzly Basketball Camps/Clinics during the dates set forth in this application and in consideration of your acceptance of the application, we/I (whether one or more) hereby release the Missouri State University-West Plains Grizzly Basketball Camps/Clinics and the Board of Governors of Missouri State University and all their employees and agents from all claims on account of any injuries which may be sustained by our/my son or daughter while attending the 2023 Grizzly Basketball Camps/Clinics and its employees and agents for any claim which may hereafter be presented by our/my minor son or daughter as a result of any such injuries.

My acceptance below is indication of my signature and approval of the waiver.

Mail checks payable to:

Grizzly Basketball Camp, c/o Jared Phay

Missouri State University-West Plains

128 Garfield Ave

West Plains, MO 65775

Deadline for Registration to be eligible for Camp Discount is June 19th

Walk-up registrations are welcome but will not be eligible for the early registration discount or guarantee correct camp t-shirt size availability.

QUESTIONS?

Contact Jared Phay by calling 417-255-7991 or email jp4e@missouristate.edu

* required field