REGISTRATION
OVERNIGHT:





DAY CAMPERS:

WHAT TO BRING:



MEDICAL CARE
     AND INSURANCE: 

 

OVERNIGHT CAMP:  COLLEGE OF  ST. OLAF

CONTACT
COACH KOZ:




APPLICATION
INFORMATION
FORM:
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PARENTAL CONSENT FORM:
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NO  REFUND POLICY:
DOCTOR'S STATEMENT OF
HEALTH OR COPY OF SCHOOL OR ATHLETIC PHYSICAL FORM:
   ***MUST BE PRESENT ID AT ARRIVAL.

    Overnight Camp registration will begin on Sunday between 1:30-3:30 p.m.  If you will be late, please call ahead and let us know when you will be arriving.  Camp will begin at 4:00 p.m. in the Main Gym.
   Overnight check-out will take place on Thursday at 2:00 p.m. before the Camp Demonstrations and Awards Ceremony which will begin at approximately 3:00p.m.  (Family, friends, we encourage you to join us!)
   
   Day Camp Registration: If you are interested in coming a day camper, the price will be lower, lunch & dinner are included and hours are
8:30 a.m.-9:00 p.m.  

   Any other information on what to bring, mail, locations, & directions will be mailed directly to you upon receipt of your camp application and enrollment.  Pillow, bedding, towel & face cloth are provided. 

   Partial Medical Accident Insurance will be supplemented by camp, included in your tuition fee.  We have a professional trainer on duty with medical facilities nearby. 
   Because of the rigorous daily schedule, each camper is encouraged to come to camp in top physical condition.  Every effort is made to protect the health and safety of the camper through the training staff, supervised warmup periods, and responsible instruction.


CAMP SESSIONS:  (PLEASE CHECK)

BOYS OVERNIGHT CAMP-ST.OLAF                      OVERNIGHT COSTS:
SUNDAY THROUGH THURSDAY                          $435 ($415 IF 5 OF MORE MAILED TOGETHER)
_____  July 17 - 21                                           $200 DEPOSIT REQUIRED  (FEE INCLUDES ROOM,
 1- BIG WEEK                                       MEALS & PARTIAL MEDICAL INSURANCE)
HIGH POTENTIAL                                                   $405 EACH 10 OR MORE
                                                                       $325 DAY CAMPER-INCLUDES LUNCH & DINNER)
                                                   (CHECK BOX) ______RETURNING CAMPER  $10 DISCOUNT

EMail: kosmoski@stolaf.edu        
CAMP PHONE: 952-926-4621      CAMP/OFFICE PHONE: 507-786-3252
CAMP CELL (During Camp) 507-304-1831     
WEBSITE: www.coachkozbasketballcamp.com

Camper's Name______________________________________________________
                                            (Last)                                                  (First)                                              (Middle Initial)
Camper's Nickname or name preferred to be addressed: __________________
Street Address:_______________________________________________________
City:________________________________________State:__________Zip:_____
Grade (as of 9/11)_____________________Age_____Height_____Weight______
Name of School (as of 9/11)____________________________________________
Parent's or Guardian Name:_____________________________________________
Room-mate Preference________________________________________________
Boy-T Shirt Size________________                  Boys Short Size:____________
Mens-T Shirt Size_______________                  Mens Short Size:____________

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                                          PARENTAL CONSENT FORM:
I hereby grant permission for my son to attend the 2011 Coach Koz Fundamental Basketball Camp Inc.  I also grant permission to the Coach Koz Fundamental Basketball Camp to act for me according to their best judgmetn in any emergency requiring medical attention and herby waive and release the camp from any all liability for any injuries incurred while at camp.
Parents or Guardian's Signature______________________________________Date:__________________

Coach Koz Fundamental Camp Inc.  Attention: Camp Director: Coach Koz Kosmoski
6017 Halifax Avenue South, Edina, 55424

For Further Information call: 507-786-3252
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NO REFUNDS AFTER JUNE 15TH, 2011
I HAVE EXAMINED _______________________AND FOUND HIM TO BE HEALTHY AND ABLE TO COMPETE IN BASKETBALL AND GENERAL RECREATIONAL ACTIVITIES (OF HIS CHOOSING) DURING THE COACH KOZ FUNDAMENTAL BASKETBALL CAMP, INC.

PLEASE LIST ANY ALLERGIES TO MEDICATIONS:____________________________________________________
LAST TETANUS SHOT__________________________________________________________________________
PERTINENT INFORMATION (DIABETES, EPILEPTIC, PERVIOUS FRACTURES, ETC)__________________________________________________________________________________________
DATE EXAMINED:_____________________________PHYSICIAN'S SIGNATURE:___________________________
PRESENT DOCTOR'S STATEMENT AT REGISTRATION ONLY.