1. 2007 FALL BASKETBALL CLINIC
Rec
Concessions
At the
T-S eive
will be sold
YMCA Of Western Monmouth County hirt
Giv and
470, East Freehold Rd., Freehold, New Jersey B
OY
YMCA of Western Monmouth County eaw
S
Thursday & Friday Gr & G ays
We build strong kids,
ad
es IRLS
November 8-9, 2007
strong families, strong communities
2-8
9:00am to 1:00pm
$85 FREE
Two Day Clinic Includes
PIZZA
Fundamental Development - Drill and Defensive Breakdown
Guest Speakers - Self-Improvement Guide and more
2007 YMCA Fall Basketball Clinic
Name: Age: Grade:
Address: City: Zip:
Phone:Home: Work: Cell #
Emergency Contact: Emergency Phone:
Insurance Carrier: Policy Number:
I hereby authorize the directors of the Fall Basketball Clinic to act for me in their best judgment in any emergency requiring
medical attention and hereby waive and release the Fall Basketball Clinic, YMCA and respective staff members from any and all
liability for injuries while at or traveling to or from the Basketball Clinic. The YMCA has my permission to involve my child in
any photographs taken for publicity purposes. I hereby approve of the terms of the above agreements. .
Parent’s Name (PRINT): Parental Signature: .
E-mail address:_____________________________________ Current School: _______________________________________
Mail application(s) to: Fall Basketball Clinic , Freehold Borough YMCA Community Center, 41 Center St., Suite 2, Freehold NJ 07728
Phone (732) 845-5273 Fax (732) 845-1594 or e-mail moneal@ymcanj.org. Make checks payable to:YMCA Fall Basketball Clinic
2007 FALL BASKETBALL CLINIC
Rec
Concessions
At the
T-S eive
will be sold
YMCA Of Western Monmouth County hirt
Giv and
470, East Freehold Rd., Freehold, New Jersey B
OY
YMCA of Western Monmouth County eaw
S
Thursday & Friday Gr & G ays
We build strong kids,
ad
es IRLS
November 8-9, 2007
strong families, strong communities
2-8
9:00am to 1:00pm
$85 FREE
Two Day Clinic Includes
PIZZA
Fundamental Development - Drill and Defensive Breakdown
Guest Speakers - Self-Improvement Guide and more
2007 YMCA Fall Basketball Clinic
Name: Age: Grade:
Address: City: Zip:
Phone:Home: Work: Cell #
Emergency Contact: Emergency Phone:
Insurance Carrier: Policy Number:
I hereby authorize the directors of the Fall Basketball Clinic to act for me in their best judgment in any emergency requiring
medical attention and hereby waive and release the Fall Basketball Clinic, YMCA and respective staff members from any and all
liability for injuries while at or traveling to or from the Basketball Clinic. The YMCA has my permission to involve my child in
any photographs taken for publicity purposes. I hereby approve of the terms of the above agreements. .
Parent’s Name (PRINT): Parental Signature: .
E-mail address:_____________________________________ Current School: _______________________________________
Mail application(s) to: Fall Basketball Clinic , Freehold Borough YMCA Community Center, 41 Center St., Suite 2, Freehold NJ 07728
Phone (732) 845-5273 Fax (732) 845-1594 or e-mail moneal@ymcanj.org. Make checks payable to:YMCA Fall Basketball Clinic