As a potential participant of the Grizzly Basketball Camp, I could possibly sustain injuries no matter how well conditioned I may be. Depending on the nature of the sport, injuries may be minor to fatal in nature. Some specific injuries that may be sustained by participants in physical activity associated with sports such as this one are as follows: stoppage of breathing, spine and neck injuries (either of which could result in paralysis), concussion, heart failure, broken legs, feet, ankles, toes or other bones, heat stroke, heat cramp, heat exhaustion, stroke, convulsion, unconsciousness, abrasions to limbs such as arms, legs and head, fainting, sudden illness, cramps, and loss of wind. Physical contact poses risks in Grizzly Basketball Camp activities as well, even though it occurs regularly as an accepted part of the sport. The propensity for major injuries, such as injuries to the spinal column, broken bones, concussion and internal injuries to major organs increases in relation to the force of impact upon contact or collision. I understand the risk of injury due to the force of a collision. I realize that if I have physical problems such as a heart condition, hypertension, orthopedic problems, or other medical problems, I should consult a physician concerning any limits to my activity. I agree to comply with all camp rules and regulations, including those given verbally and in writing. I also agree to participate in safety meetings and the presentation of any safety material, such as a video on safety, which are designed and offered to promote safety in all camp activities. Knowing the inherent risks, dangers and rigors involved in the activities in which I choose to participate at this camp, I certify that I am fully capable of participating in the activities offered. I certify that I have read this ACKNOWLEDGMENT OF RISK Form and understand all of its terms.

Signature of Participant Date

Print Name

Signature of Participant’s Legal Guardian(if participant is under the age of 18)

Print Name Date

Julie Tonkin Hoyt Athletic Complex Missoula, MT 59812

Ph 406-243-5334 | Fax 406-243-2265 tonkinja@mso.umt.edu | www.gogriz.com

Online registration available at https://camps.jumpforward.com/grizmbb

ACKNOWLEDGMENT OF RISK FORMfor Participants of Sports Camps

NAMe OF CAMP

DATeS OF CAMP

Insurance: each camper must provide their own accident insurance. A statement of physical fitness to participate in sports is required from your doctor. Camper confirmation forms and additional information will be sent upon camp application arrival. Confirmation Preference: o Email o Mail

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Day Camp Medical Authorization

PLEASE FILL OUT THIS SIDE AND RETURN FOR DAY CAMP!

Each participant must fill out acknowledgment of risk form and return with camp application. Forms must be turned in at check in for each player.

Doctors will not treat minors without written permission from parents: Therefore, it is necessary that the following statement be signed and in our files.

“I hereby request and authorize the proper authorities of Grizzly Basketball Camp to refer my son to a clinic selected by the basketball school, for treatment, illness or injury or both; and I further authorize the Physicians selected by the Basketball Camp to treat said injury or illness as they think best for the most advantageous welfare of the patient.” I also waive the Grizzly Basketball Camp from any financial responsibility from illness or accident while at camp as such costs will be covered by our personal medical insurance.

Parent or Guardian

Insurance Company & Policy No.

o $255 - Resident Camper 3 night stayo $205 - Commuter Camper with Meals

Camp Application$50.00 deposit must accompany application.Balance to be paid upon arrival. After June 7th, deposit is non refundable.

Name (please print)

Age T-Shirt Size-Adult (Circle One)

Mailing Address

City State Zip

Phone e-mail Address

Grade entering

School

Camp roommate request (Overnight Only)

Parent/Guardian Signature

ADVANCED SKILLS CAMP June 26-28

DAY CAMP 1 - June 19-22o $175 - One Session

DAY CAMP 2 - Ju ly 1 1 - 14o $175 - One Sessiono $300 - Both Sessions* If registering online for both day camps contact tonkinja@mso.umt.edu for discount code

Make checks payable to:GRIZZLY BASKETBALL CAMPS UNIVERSITY OF MONTANAC/O JULIE TONKIN HOYT ATHLETIC COMPLEXMISSOULA, MT 59812 tonkinja@mso.umt.edu

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TEAM CAMPJune 9 - 11

DAY CAMP SESSION 1June 19 - 22

ADVANCED SKILLS CAMPJune 26 - 28

DAY CAMP SESSION 2July 11 - 14

www.gogriz.com

Online Registration athttps://camps.jumpforward.com/grizmbb

Acknowledgment of Risk Form online.

2017 Grizzly Basketball

Camps

Message from Coach DeCuire

My staff and I are excited to run our fourth summer of Grizzly Basketball Camps, and look forward to an environment of great competition, instruction, and learning. Grizzly Basketball Camps are about you and your team, which is why it is our mission to provide the opportunity to have fun playing quality basketball at an affordable cost. Grizzly Basketball Camps have grown in size the previous three summers and we hope to continue that trend. At our camps, you will get quality, fundamental instruction and time for coaches to interact and share ideas. We look forward to having you at camp and being a part of “Griz Nation.”

See you this summer,

Travis DeCuireHead Basketball Coach

TEAM CAMPJune 9- 1 1

High School Varsity, JV and Frosh Teams

CoST PER TEAMCommuter $600 1 Night Stay (Saturday) $700 2 Night Stay (Friday/Saturday) $800Starts at 4:00 pm Friday and ends at 1:00 pm Sunday

• Housing provided for all teams and coaches• Each price max of 10 players, 2 coaches

Additional players/coaches: $35 per person• Teams responsible for all meals• Outstanding indoor facilities for all games• Quality competition for all levels• Coaches Social• Team bonding opportunity• Camp T-shirt for each camper and coach• Fun for all teams• Doctors physical required - school year OK• Games begin Friday evening • Emphasis in scheduling teams outside your region -

Guaranteed 5 Games• No online registration available

ADVANCED SKILLS CAMPJune 26-28

Entering Grades 5-12

Resident Camper 2 night stay $255Commuter Camper $205Begins at 1pm Mon. June 26 and ends Wed. June 28 at 1pm

• Skill development• Individual fundamental instruction from Grizzly

coaching staff and players• Great competition for all ages and levels• Outstanding facilities and accommodations• 5 on 5 league and competition• 3 on 3 league and competition• 1 on 1 competition • Fastbreak league • Hot shot competition • Free throw competition• Chance to meet new friends• Camp ball and T-shirt• Doctors physical required-school year OK• Griz Basketball Facilities Tour• Fun for all campers• Every camper will have meals

DAY CAMPDay Camp 1 June 19-22Day Camp 2 July 1 1 - 14

Entering Grades K-7

Day Camper $175Day Camper both sessions $300

8:30 am - 12:00 pm all 4 days

• Skill development• Individual fundamental instruction from Grizzly coaching staff and players• Competitions for all levels and ages• Chance to meet new friends• Camp ball and T-shirt• NO DOCTORS PHYSICAL NEEDED• Fun for all campers• Lunch provided• Griz Basketball Facilities Tour

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TEAM CAMPREGISTRATION

June 9- 1 1

High School (please print)

School Phone #

High School Mailing Address City State Zip

Head Coach

Home Phone # Cell Phone #

e-mail

Home Mailing Address

Number of teams you intend on bringing to camp

Coaches Shirt Size-Adult (circle one): S M L XL XXL

o $600 - Commuter Teamo $700 - 1 Night Stay (Saturday) o $800 - 2 Night Stay (Friday/Saturday)

IF You PLAN oN BRINGING MoRE THAN oNE TEAM we will need a $100 deposit to secure their spot(s) in camp. We will not secure a spot for more than one team until we receive the deposit money. Please make checks payable to: Grizzly Basketball Camps

each participant must fill out acknowledgment of risk form and return with camp application. Forms must be turned in at check infor each player. If there is not a form for each player on the team, that player will not be able to participate in team camp.

*Upon receiving this completed form we will send you confirmation forms, a housing form and dorm check-in information! Plus be sure to return form along with check.

Confirmation Preference: o email o Mail

$100.00 deposit must accompany application to secure spots for teams. Return completed forms to:

GRIZZLY BASKETBALL CAMPS uNIVERSITY oF MoNTANAC/o JuLIE ToNKIN HoYT ATHLETIC CoMPLEXMISSouLA, MT 59812 tonkinja@mso.umt.edu

Doctor’s Health CertificatePlease have your physician sign this certificate or

bring one of your own on or before arrival at camp.

PLEASE FILL OUT AND RETURN DOCTOR’S HEALTH CERTIFICATE FOR OVERNIGHT

CAMP ONLY. PHYSICAL USED FOR SCHOOL FUNCTIONS PERMISSIBLE. SEE REVERSE SIDE

FOR DAY CAMP MEDICAL AUTHORIZATION AND ALL INSURANCE INFORMATION.

I have examined:

and find him free of any illness and physically fit to participate in basketball and other outdoor sports.

Age (please print) Weight Height

Date of last tetanus shot

Please list any suggestions as to his general health and/or treatment you feel that we should know.

Physician’s Signature

Address

Date