Team Name: _____________________________________________________ Coach Name: __________________________ Cell Phone: ______________________ Coach’s Home Address: ______________________________________________________ Street ______________________________________________________ City State Zip code Coach’s Email Address: _______________________________________________________ Date: June 19-­‐21, 2015 Time: June 19th 1-­‐10pm th
June 20 8am-­‐10pm June 21st 8am-­‐8pm ***These times are subject to change depending on how many teams we have sign up. Location: Halton Arena and Hayward Practice Facility Cost: One day ONLY $100 team fee + $15 per player Two days (please specify which 2 days) $150 team fee + $15 per player Three days $200 team fee + $15 per player Division (Circle One): JV V Competition Level (Circle one): 1 2 3 4 (4 = highest) Days Attending (Circle One): 19th 20th 21st Team Fee : ________ Number of players attending (please also attach a roster or attendee list with t-­‐shirt sizes) ____ x $15= ________ Total Camp Payment: ________ *MAKE ALL CHECKS PAYABLE TO: CARA CONSUEGRA LLC
*The Team Fee is due by May 31st and is NON-­‐REFUNDABLE. *You must fill out a Medical Release Form for every player that will be attending OR submit a copy of a current physical.
Hotel Hampton Inn & Suites Homewood Suites 8419 N. Tryon Street 8340 N. Tryon Street Charlotte, NC 28262 Charlotte, NC 28262 704-­‐548-­‐0905 704-­‐549-­‐8800 *Ask about the shuttle to campus *Both Include free full hot breakfast *RATE is $89.00. Please ask for the Charlotte Women’s Basketball Team Camp Rate
Return by Mail: Return by Fax: Return by Email: Charlotte Women’s Basketball Attn: Nicole Woods Nicole Woods Attn: Nicole Woods 704-­‐687-­‐5360 [email protected] 9201 University City Blvd Charlotte, NC 28223 All Charlotte 49ers Camps and Clinics are open to any and all entrants and are only limited by age, gender or grade level.