2015
alma college men’s baske tball
VARSITY AND JV TEAM SHOOTOUT
VARSITY AND JV TEAM SHOOTOUT
Friday, June 19 - Sunday, June 21, 2015
Alma College Head Men’s Basketball Coach Sam Hargraves and the men’s basketball program will host a
three-day overnight team shootout for varsity and junior varsity teams and their coaches. Each team will
participate in four pool-play games per day with each game focused on encouraging quick, highly competitive
play. Games are played in the beautiful Art Smith Arena.
Please bring basketball shoes, reversible practice jerseys (light and dark) and a change of clothing if staying
overnight.
Enrollment is limited to 30 teams, accepted on a first-come, first-served basis.
- $50
( or
full payment ) by
J une 12, 2015
Cost: $150 per day/team for one day, $125 per day/team for two days or $100 per day/team for all three days
Camp fee guarantees four games per day and includes a t-shirt for players and coaches
camp fee
deposit per team
shootout details
Format: Four games per day with officials — scheduled in one-hour blocks.
Exact game times will be e-mailed to each coach a few days prior to the start of the shootout.
Please be sure to arrive 45 minutes before the start of your first game to allow time for check-in and warm ups.
Play will begin and 9:00 a.m. and conclude no later than 10:00 p.m.
Please make specific scheduling requests a week in advance!
medical policy
Campers must have their own medical insurance. An athletic trainer will be available on campus during the clinic.
refund policy
If, for any reason any team cannot attend, a full refund will be given if notified by June 17, 2015.
overnight policy
Campers staying overnight must bring linens, blankets, pillows, fan, towels and all bathroom/shower items.
Dorm rooms are available for $30 per camper/assistant coach per night.
Head coaches of each team receives a free room.
if you have any questions , please call (989) 463-7106 or e - mail coach hargraves at hargravessr @ alma . edu .
CAMPER REGISTRATION
camper information
Full name:_________________________________________ Preferred name:____________________________________
Street address:_ ______________________________ City:______________________State:_______ Zip code:_ __________
School Name:___________________________________________ Grade in fall 2015: ______________________________
T-shirt size: Adult p S p M p L p XL
Parent/guardian: ____________________________________
Daytime phone:__________________ Evening phone:_________________ E-mail:________________________________
Do you require any special housing accommodations? If so, please describe:
__________________________________________________________________________________________________
media release
I give permission for the Alma College Basketball Camp, its staff and volunteers to take photographic and video images of my
child and to use those images in marketing, promotional and program materials as deemed appropriate.
______________________________________________ ________________
Signature of parent/guardian
Date
liability release
I, the undersigned parent/legal guardian, give permission for my child to attend and participate in Alma College Basketball Camp.
I understand that this event will take place at Alma College and that my child will be under the supervision of Alma College
Basketball Camp designated individual(s).
I hold Alma College and all staff and volunteers harmless for any injury or incident involving my child. In case of a medical
or dental emergency, I give my consent and authorization for any necessary treatment, to include treatment by a licensed
physician or dentist and transfer to any hospital reasonably accessible.
It is understood that the signature on this consent form by one parent or guardian implies the consent of the other. By signing
below, I am stating that the above information is complete and truthful.
______________________________________________ _________________
Signature of parent/guardian
Date
health / insurance information
insurance information
Name of Participant:_________________________________ Policy Holder’s Name: ______________________________
Policy Name: _______________________________________ Policy No.: _______________________________________
Primary Care Physician: ______________________________ Physician’s phone number: _ _________________________
health information
Known allergies? _ ___________________________________________________________________________________
Are you taking any prescription medications? Medications must be in the original bottle/package labeled with the name of the
person who is taking them. Please list the name(s) of medications and instructions for administering them:_ _______________
__________________________________________________________________________________________________
Do you have any chronic health concerns or physical restrictions:_ _______________________________________________
TEAM REGISTRATION
team information
( coaches
must complete this portion for their team )
School name:_______________________________________ JV p Varsity p
School address:_______________________________ City:______________________State:_______ Zip code:_ __________
Coach’s name:_ ________________________________________________________
Coach’s cell phone:________________________________________________ Email: ______________________________
probable roster
Name________________________________________
1. _________________________________________
2. _________________________________________
3. _________________________________________
4. _________________________________________
5. _________________________________________
6. _________________________________________
7. _________________________________________
8. _________________________________________
9. _________________________________________
10. _________________________________________
Grade _ _______________________________________ Shirt Size
_____ _______________________________________________
_____ _______________________________________________
_____ _______________________________________________
_____ _______________________________________________
_____ _______________________________________________
_____ _______________________________________________
_____ _______________________________________________
_____ _______________________________________________
_____ _______________________________________________
_____ _______________________________________________
*Please fill out a separate form for each additional team you plan to register*
Mail your completed application and payment to:
Sam Hargraves, Head Men’s Basketball Coach
Alma College
614 W. Superior St.
Alma, MI 48801-1599
Please make checks payable to Alma College Men’s Basketball.
A complete application includes both the team registration form and registration deposit.
*Camper registration forms may be turned in upon arrival
Registration Fee: $50 deposit per team (or full payment) by June 12, 2015
$150 per day/team for one day, $125 per day/team for two days or $100 per day/team for all three days.
* Teams can choose to participate in either one, two or all three days of camp.
Lodging Cost: Head coach - Free; camper/assistant coach - $30 per night (Friday, Saturday, or both)
Lodging request: Friday, June 19 p Saturday, June 20 p Both p None p
Please check the days you plan to attend:
Friday, June 19 p Saturday, June 20 p Sunday, June 21 p All p
*Please fill out a separate form for each additional team you plan to register*