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2014 Basketball Camp Registration

MEYERS LEONARD BASKETBALL CAMP

Please send APPLICATION, COMPLETED AND SIGNED HEALTH & CONSENT FORM (both in this brochure) and $100.00 payment to save position at camp.

___________________________________________ Name

___________________________________________ Address

2014

___________________________________________ City State Zip

___________________________________________ Emergency Phone Number

___________________________________________ E-mail

___________________________________________ Age Height

___________________________________________ Name of Parent or Guardian

___________________________________________ School

Grade (Sept. 2014)

Please Select the Session of Choice [ ] 1st-8th Grade Boys Camp [ ] High School Boys Camp

Payment

PAYABLE TO: Meyers Leonard MAIL TO: Meyers Leonard 1700 N. Lincoln Robinson, IL 62454

Amount enclosed: $ ________

If your choice of payment is debit or credit card, you will need to register online at makingmeyers.com.

Permission to Photograph Campers

As a parent/guardian, I have read and hereby accept the conditions described in this brochure. I also understand that Meyers Leonard Basketball Camp staff retains the rights to use photographs of campers taken at camp for publicity and/or advertising purposes.

___________________________________________ Signature of Parent or Guardian

For more information about the camp and Meyers Leonard, please check out his website www.makingmeyers.com. This website will give you inside details about his summer plans, workout routines, diet and much more!

Register online @ makingmeyers.com

Home Telephone

1ST-8TH GRADE BOYS & HIGH SCHOOL BOYS CAMPS

ROBINSON HIGH SCHOOL


Meet Meyers

Meyers Leonard is excited to introduce his first annual basketball camp. Meyers is a professional basketball player who just finished his second season with the Portland Trail Blazers. Meyers graduated from Robinson High School, where he led his team to win the Illinois Boys Basketball State Championship in 2010. He then accepted a scholarship offer to play at the University of Illinois, where he spent two years before deciding to enter the NBA draft. Growing up in Illinois has meant everything to him and he is excited to give back and inspire young players in the community.

Guest Kim Hughes

Coach Kim Hughes played at the University of Wisconsin from 1971-74, averaging 15 points and 12 rebounds. Hughes was drafted into the ABA in 1974 by the New York Nets and won the ABA championship in 1976 alongside Julius "Dr. J" Erving. After a 16-year professional career, Hughes began working in the NBA front office. Over the last 20 years, Kim has had a variety of jobs such as an NBA scout, assistant coach and head coach. Currently, Kim is an assistant coach for the Portland Trail Blazers and works very closely with Meyers.

About the Camp Dates: June 25-27 Price: $100

A majority of these proceeds will benefit Robinson High School Athletics, Highland Church of Christ and the Sam Mitchell Benefit.

Location: Robinson High School 2000 North Cross Street Robinson, IL 62454 Sessions: 1st-8th Grade Boys: 8am-11am High School Boys: 1pm-4pm

Camp Highlights

Facility: The camp will be held in the Robinson High School gymnasium. This facility is air conditioned with two full-sized courts. Instructional Evaluation: We organize the camp into levels based on ability, size, skill and strength. We try our hardest to make sure each player is in a group that is both comfortable and challenging. Limited Enrollment: The camp is limited to allow the best possible experience. We urge you to send in your application early. Camp Freebies: Players will receive a Meyers Leonard Camp T-Shirt, signed picture, photo opportunity and camp report card. Individual Attention: Our qualified staff will spend time with every player to make sure they have a personalized and rewarding experience.

Health and Consent Form _____________________________________________ Participants Name

______________________________ _____________ School

Age

I hereby give my consent for the above named student to compete and participate in the Meyers Leonard Basketball Camp. I, the undersigned, hereby release and discharge Meyers Leonard, the employers and operators of the Meyers Leonard Basketball Camp and Robinson High School, their officers, employers, agents, servants and volunteers (herein collectively referred to as ("Camp/ Club") from all liability arising out of or in connection with the above described activity or all liabilities associated with any and all claims related to such activity that may be filed on behalf of or for the above named minor. For the purposes of this agreement, liability means all claims, demands, losses, causes of action, suits or judgments of any and every kind that occurs during the above described activity and that results from any cause including the active or passive conduct and/or negligence of the Camp/Club. I acknowledge on my behalf and on the behalf of the above named minor that there are risks that are inherent in the above-described activity, including risk of serious injury that may occur through the conduct of other participants, coaches, Camp/Club, including conduct that may not be part of the ordinary risks of the activity itself. For example, injury may occur through conduct that is not authorized by the rules and regulations of the activity. This release and waiver as set forth in the above paragraph shall also apply to this type of conduct and any resulting injury. I also represent that the above name participant has undergone a medical examination by a licensed physician within one year preceding the date this document is signed, is in good health, and fully able to participate in the activities provided by the camp, including activities which are strenuous in nature. I have carefully read this waiver and release of liability and fully understand its terms and conditions and understand that by signing this document that I have given substantial rights for the named participant/minor and myself.

___________________________________________ Signature of Parent or Guardian

___________________________________________ Print Name of Parent or Guardian

Date

Meyers Leonard Basketball Camp  
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