| NEXT LEVEL BASKETBALL APPLICATION FORM Payment in full BEFORE deadlines guarantees your spot in camps ! send a $50.00 Non-Refundable deposit * for Spring & Fall, $100.00 non-refundable deposit* for Summer *(Deposits/payments are refunded ONLY if enrollment limit is met before your application is accepted!) *ALL BALANCES ARE DUE UPON ARRIVAL, ON THE FIRST DAY OF CAMP! (Bank fees apply to NSF checks) click here to review------------> (Please circle) - SPRING SUMMER FALL (10 sessions $250) (16 sessions $300/$320) ( 12 sessions $240) NEXT LEVEL BASKETBALL 2009 (summer camp only) Player's Name:_______________________________________________________ Age________Shirt Size__________ Parent's/Guardians:______________________________________________________________________________ Address:__________________________________________________________________ Zip:____________________ Emails:__________________________________________________________________________________________ Phone no's, cells,work:________________________________________________________________________________ School:_________________________________________________________________Grade(next season):___________ Coaches Name:_____________________________________Phone/Email:______________________________________ Note: You must provide your own health insurance. I fully understand that Next Level Basketball, Brighton Academy, Gables Academy, staff, school, gym, or anyone associated is acting in good faith and good intention and I WILL NOT hold them liable or responsible in case of accident or injury. Parent/Guardian signature:___________________________________________________________ Player's signature:__________________________________________________________________ Insurance Co./Policy No.____________________________________________________________ ---------------------------------------------------------------------------------------------------------------------------- Office use only: Deposit: $___________________ Date Recieved_____________________Check No.______________ Payment : $____________________Date Recieved_______________________Check No.___________ |
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| Please print & send application and check or money order payable to: Coach Jim McCartt 4949 Stumberg Lane #227 Baton Rouge, La. 70816 |
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