2010 Hoop Mountain PA & Basketball Stars of America Camps & Recruiting Showcases Registration Form
Name: ___________________________________________________________________________________
Date of Birth: _____________ Grade (Entering next fall): _____________ Graduation Year: _____________
School: _________________________________ School City & State: ___________________________________
Height: ________ Primary Position: ________ Jersey Size: ________ Sneaker Size: ________
Home Street Address: ___________________________________________________________________________
City: _______________________________________________ State: ____________ Zip: ____________________
Phone Numbers: _______________________________________________________________________________
Email: _______________________________________________________________________________________
Insurance Carrier: ______________________ Policy #: ___________________________________
High School Players Only: Are you currently being recruited by any colleges? If yes, please list schools or level:
GPA: _______ ACT/(P)SAT Score: ________ College Basketball Level You are Interested In: __D1 __D2 __D3 __Other
2010 Hoop Mountain PA & Basketball Stars of America Basketball Camps and Showcases (Please check all attending):
Boys Overnight Super Weeks: ____ July 5-8 @ SRU ____ July 29 to 31 @ Erie FF ____ August 1-4 @ SRU
Boys Overnight Specialty Weeks: _____ July 18-20 @ SRU _____ August 1-4 @ SRU
Boys Recruiting Showcases: ____ May 8 @ Kiski School ____ July 12 @ Kiski School ____ July 31 @ Erie FF
Girls Overnight Super Weeks: ____ July 5-8 @ SRU ____ August 1-4 @ SRU
Girls Overnight Specialty Weeks: _____ July 18-20 @ SRU _____ August 1-4 @ SRU
Girls Recruiting Showcases: ____ July 31 @ Erie FF
Robert Morris Day Camp: ____ July 19-22
North Allegheny Day Camp: ____ June 28 to July 1
Hempfield Day Camps: ____ June 14-17____ June 21-24 ____ August 2-5
Monroeville Day Camps: ____ June 28 to July 1 ____ August 9-12 ____ August 16-19
Hillcrest Day Camps: ____ July 12-15 ____ July 26-29 ____ August 9-12
July 9-11 Summer Classic Tourney: ____ Team ____ Player (Overnight) ____ Player (Commuter)
Overnight Camp Transportation Needed: ____ From/To: ___Airport ___Greyhound Station ___Amtrak Station (Extra Cost of $25 each way)
DISCOUNT CODE: _______________________________
Waiver: I understand that I am enrolling my child in the Hoop Mountain PA & Basketball Stars of America Basketball Camps, Recruiting Showcases & Tournaments and that Hoop Mountain PA, BSA, Coach Daryn Freedman and any facilities that are used or any coaches will not be liable for any injuries incurred during participation in the program. I also understand that there are no refunds! If a player is injured and can’t continue, he or she will receive a prorated credit towards another Hoop Mountain PA/BSA program. The applicant is in good health and able to participate in the physical activity of a vigorous program. The camp has my permission to provide emergency medical care in the event my son is injured or ill. I understand that Hoop Mountain PA/BSA retains the right to use, for publicity and advertising purposes, all photos and video of campers taken during camp.
Signature of Parent/Guardian: ___________________________________________ Date: ____________________
To reserve a spot in any camp, please send a $100 non-refundable deposit or full payment. To take advantage of the Early Bird Discounts (prior to June 10, 2010) you must send full payment! If you send a deposit, full payment is due by first day of camp.
Please mail completed registration form along with a check made out to: Basketball Stars of America LLCTo: BSA/Hoop Mountain PA Basketball, ATTN: Coach Daryn Freedman, 547 Burkes Drive, Coraopolis, PA 15108