Midnight Madness

Fall Basketball Camp

Hosted by North Paulding Basketball
*Saturday September 6th*
*6 p.m. to Midnight*
*Boys and Girls 2
nd
through 8
th
grade*












Waiver: The above participant is in good health and has my permission to participate in this camp. In case of
emergency, I hereby give permission for my child to be given emergency medical treatment by on-site medical
professionals, a local doctor. Hospital, or dentist and hereby waive and release said camp from any and all liability
from injuries incurred while attending camp and payment of said services are the total responsibility of the parent.

Parent Signature:________________________________________ Date:____________________________
Cost:
* $50 preregistered *
* $65 on day of camp *
o Checks made payable to NPBPGC
o Register by mail to
Attn: Coach Green/Coach Dyer
North Paulding High School
300 North Paulding Drive
Dallas GA, 30132
o Register online at
www.NorthPauldingbasketball.net
Activities:
Basketball skills and fundamentals
Competitions Hot Shots, Free Throws, 3
pointer, Obstacle course
Scavenger Hunt
Fun Activities
Pizza dinner
Snacks and drinks provided
Fun with Varsity boys/girls players and
coaches
Participant Name:____________________________________Gender:__________
Age:________________ Grade (20014-2015 school year):___________
Parent Name(s):________________________________
Address:__________________________ _________________________________
Home/Cell Phone:___________________ Email:____________________________
Emergency Contact #:_________________________________________________
*Insurance Information Name on Policy:____________________
Company:_________________________
Policy Number:_____________________