Application

Mark Fox Basketball Camp

100 Smith Street Athens, GA 30602

2014
Mark Fox Team Camp

CONTACT INFORMATION
High School: ______________________________________ Coachs Name: ___________________________________ Email: ____________________________________________ Cell: (_____) _______ - ________

SCHOOL INFORMATION
School Address: ____________________________________ School City: _________________ ST: ______ Zip: _________ Phone: (_____) _____ - ______ Fax: (_____) ______ - ______

TEAM CAMP
June 21-22 Varsity Junior Varsity Will you be staying overnight in our dorms? Yes No Number Of: ____ Campers ____ Coaches (including head coach) ____ Additional Personnel

Total number of teams coming: ____

Make Money Order Payable to: MCFOX ENTERPRISES

Saturday and Sunday

School and Booster Club Checks will be accepted

Please fill out the information above and return by May 31st

June 21-22, 2014

For more information, call:

706-542-1143

Basketball office

Consent Forms Head Coach Mark Fox

The Mark Fox Team Basketball Camp is a great opportunity for your team to improve their sportsmanship, teamwork, execution, as well as many other areas of the game. We will provide a competitive atmosphere as each team will play a series of games against other high school competition. Games will take place in the newly renovated Stegeman Coliseum and our state of the art practice facility. My staff and I invite you to be a part of this exciting weekend of basketball. This camp will not only allow your team to grow as individuals and as a unit, but will allow you to gain an edge on your competition for this upcoming season. Remember, championships are won during the season, but champions are made during the summer. I look forward to seeing you here this summer! Go Dawgs!

Team Camp Information

Registration: Registration will be held in Stegeman Coliseum. Dining: Teams will enjoy the excellent food in the dining halls on campus. Housing: Boarding players and coaches will be housed in University housing properties. Teams will be charged $50 for any lost keys. Any damages to rooms will be billed from housing and sent to coaches. Campers need to bring all bed linens, pillow, towel, toiletries, etc. Assistant Coaches / Managers: Meals for team and one coach are included in price. Other team personnel including additional coaches, managers, and bus drivers will be charged $40 for meals for commuters and $60 if residing overnight. Facilities: Games will be played in the newly renovated Stegeman Coliseum, our state of the art practice facility, and the Ramsey Student Center. Emergencies: Contact Kent Davison at (706) 542 6308

Parental Consent
The Law requires that parental permission be obtained for operative procedures on minors. The following consent form should be signed by parents so no delays occur with operative procedures. However, no operation will be performed, unless emergency, without parents being contacted. I, as the parent or guardian, have actual knowledge and appreciation of the particulars of the camp including those risks involved in participation in basketball camp, and hereby voluntarily consent to said minors participation and assume the risks arising there from.

Signed:_______________________________________ Relationship to Camper:_________________________

Release and Waiver

In cooperation of my childs/dependents participation in the Mark Fox Basketball Camp, I do hereby, for myself, my child/dependent, my heirs and executors, waive release and forever discharge all rights and claims for damages and/or injuries for which I or my child/dependent may have, or which may hereafter accrue to me or my child/dependent against Coach Fox and its employees and agents, and the University of Georgia, for any and all injuries and/or damages which may be suffered by my child/dependent in connection with my childs/dependents participation. Additionally, I hereby provide a grant of license and a release to use the name and photo of my child to publicize the camp for a period of two years. I have read and understand the release and waiver of claims statement and fully agree with the provisions of the document.

Head Coach Mark Fox University of Georgia

The

TEAM CAMP
June 21-22
Open to HS Varsity and JV team $100 Team Fee $115.00 per overnight camper/with meals $90.00 per commuter camper/with meals $85.00 overnighter/ no meals $60.00 commuter/ no meals $60 Additional coach / manager overnight Fee $40 Additional coach / manager commuter Fee One Day Option $50.00 Team Fee $30.00 commuter/ no meals 6 games provided for each team Camp T-shirt for each player

Medical Information: Medical forms must be submitted for each player. Copies of high school physical forms from within the last year are acceptable. Cancellation: A $100 administrative fee will be charged. Discipline: Any serious violation of camp rules or regulations could result in immediate dismissal from camp. There will be no refund in this situation. Insurance: Campers are required to provide their own medical insurance. A trainer is on duty at all times. Doctors are on call throughout the camp.

Signed:_______________________________________ Relationship to Camper:__________________________

Physicians Statement
I hereby certify that I examined ___________________ and find him physically fit to attend and participate in the Mark Fox Basketball Camp, and I know of no impairments which would limit his participation in all activities in camp. Comments:___________________________________ Date of last tetanus immunization:________________ Date examined:________________________________

Saturday Schedule
10:00 AM 10:30 AM 11:00 AM 10:00 PM Registration Begins Coaches Meeting/Skill Instruction Games Begin Games End

Sunday Schedule
8:00 AM 1:00 PM Games Begin Games End

Physicians signature:___________________________