Wildcat Basketball School Application Form

(please fill out and return)

 

(Please check the appropriate box)

 

                    ________   COED      Grades 3 - 4        June 25 – 29, 2007

 

                    ________   Girls         Grades 5 – 8       July 9 – 13, 2007-03-29

 

                    ________   Boys         Grades 5 - 8        July 16 – 20, 2007

 

 

 

 

 

 

 Student Name   ______________________________________________________________________

 

 

Address   __________________________________________________________________________

 

 

 City   ________________________________     State   ________________     Zip   ________________

 

 

Home Phone   _______________________________________________________________________

 

 

Name of Emergency Contact   ___________________________________________________________

 

 

 Grade (2007-2008 School Year)   __________     Birth Date   _________________     Gender   __________

 

 

Parent/Guardian Name   ________________________________________________________________

 

 

Signature   __________________________________________________________________________

 

 

Shirt Size

(Circle one)

Youth:   S   M   L        Adult:  S  M  L  XL

 

 

INDIVIDUAL RATE:    $180

            (daily lunch & T-shirt included)

Family discounts available

Non-refundable deposit of $40 required with application

Balance due one week prior to attending

 

 

Please make checks payable to

Nashua Catholic