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Long Island’s Finest Shooting Day Camp

Registration Form

Text Box: This registration must be followed by a $100 non-refundable, non-transferable check for each session within 7 days. Otherwise the registration will not be considered valid. Please mail to: BRUNS CAMP—16 E. POPLAR ST. — FLORAL PARK, NY 11001 Phone: 516-328-9060

(For office use only—Camper #)

Choose your session(s):

Price each

$50.00

$310.00

*Total:

Camper Name:

Street Address:

Phone

(Home and Cell)

E-mail:

Shirt Size

School

Youth

Adult

Attended Before

Recommended by:

I hereby authorize the BRUNS BASKETBALL CAMP to act for me according to their best judgment in any emergency requiring medical attention.

I recognize that my typed name below acts as my signature.

Name

Date

BRUNS BIG APPLE BASKETBALL CAMP

Grade in Sept. 2012

$310.00

*SUBTRACT $20 PER SESSION

FOR TWO OR MORE SESSIONS!

For Office Use Only

Deposit

Balance

Medical Form

St. Paul’s Session: June 25—June 29 5 Days

Island Garden Session: July 23—July 27 5 Days

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