Sign-up Form

MADISON HOOP DREAMS February Vacation Information

We are offering a basketball camp during the February vacation at the Robert H. Brown Middle School from 9AM to 3PM on February 15 – 19 as a service to parents who are working that week and an opportunity for players who love the game and want to get better. There will be daily instruction on all aspects of basketball. In addition, there will be contests and several games each day. Our objective will be to help each player improve their game and to have a week of fun! The cost is $195 per camper. For two or more/family the cost is $175 /camper. On a daily basis, the cost is $50 per day. However, a 4 day rate is $175.00. Since the camp is limited to 40 campers, I encourage you to register ASAP to be sure of a spot for your son or daughter.

Starts:	2/15/2010 - 2/19/2010
Days of the Week:	Monday, Tuesday, Wednesday, Thursday, Friday
Time:	9:00 AM - 3:00 PM
Grades:	3, 4, 5, 6, 7, 8, 9
Size:	40
Location:	Robert H. Brown Middle School Madison, CT 06443
Cost:	$195.00 ($175.00 for two or more children, or for two or more weeks) or $50.00 per day.

Sign-up Form

Child's Name:

First: Middle Initial: Last:

Sex:

Grade:

Height:

feet, inches

Weight:

pounds

Age:

Please select the day(s) your child will be attending:

Monday 2/15Tuesday 2/16Wednesday 2/17Thursday 2/18Friday 2/19

Parent's Name:

First: Middle Initial: Last:

Address:

(Street Address)
(Apt, Suite)

City:

State: Zip Code:

Home Phone:

( ) -

Emergency Phone:

( ) - Ext.

E-mail:

e-mail is required for confirmation of the deposit and for further camp information
Notify me of upcoming events

Confirm E-mail:

Insurance Carrier:

Policy Number:

Type the following verification code into the box below: