TEAM CAMP June 10-11 $125 per player overnight (includes meals & housing) $105 per player commuter (no housing) Each team receives instruction and plays at least six games against teams of similar ability. Teams are divided into leagues based on coaches’ choice. Leagues include: Varsity, Junior Varsity and AAU. Each camper receives a camp T-shirt. Camp cost covers instruction, officiating, facilities and secondary camp insurance. Instruction includes strength and conditioning, study skills, nutrition, team building and NCAA rules. Teams play in Tad Smith Coliseum, Turner Center, BPF and Gillom Center. An overtime tournament is played with details closer to camp. Each team must provide their own transportation. Cost per assistant coach or chaperone is $75, which includes housing, T-shirt and meals. Each team must have at least 8 players and reserve a spot with a deposit of $50. Camp application and deposit must be received by May 31 to prepare bracket. I NDIV I DUAL CAMP I June 11-13 Ages 8 – ‘12 seniors $265 overnight / $225 commuter Please note Coach Wiggins will not be in attendance at this camp due to his participation in the WBCA Center of Coaching Excellence. Ole Miss’ Individual Camp focuses on improving fundamentals and is designed for the development of each player regardless of size, age, ability or prior experience. Campers are divided by age and skill level and participate daily in skill stations, league play and skill competitions. Camp cost covers instruction, facilities, meals, secondary camp insurance and lodging, if applicable. Each camper receives a camp T-shirt. All campers are encouraged to sign up for the annual Talent Show. Be sure to bring your costumes and props to camp! Camp application and $50 non-refundable deposit must be received by June 5. I NDIV I DUAL CAMP II June 18-20 Ages 8 – ‘12 seniors $265 overnight / $225 commuter Camp application and $50 non-refundable deposit must be received by June 12. E LITE POS IT I O N CAMP June 22-23 Ages 14 – ‘12 seniors $120 overnight / $100 commuter Elite Position Camp is designed for the advanced player at an affordable price. This camp is open to all players ages 14 to 2011 seniors and is centered on position-specific instruction for the highly motivated individual. Campers should be prepared for a high intensity, college-level experience. Campers are coached by the Ole Miss staff and players. Camp cost covers instruction, facilities, meals, secondary camp insurance and lodging, if applicable. Camp application and $50 non-refundable deposit must be received by June 15. T EAM SHOOT-OUT June 23 • $225 per team Shootout is an exciting day of game instruction and competition. Each team is placed in a competitive environment with MHSAA trained officials and receives the opportunity to play three guaranteed games. All players and coaches get a camp T-shirt. Meals, lodging and transportation are NOT included. Camp cost covers instruction, officiating, facilities and secondary camp insurance. Camp application and $50 non-refundable deposit must be received by June 15 to prepare bracket.

REG I ST RAT I ON F O RM

Complete and mail this form with your $50 nonrefundable deposit to:

Camp Name * Cost

□ TEAM CAMP Overnight (per player) $125

□ TEAM CAMP Commuter (per player) $105

□ INDIVIDUAL CAMP I Overnight $265

□ INDIVIDUAL CAMP I Commuter $225

□ INDIVIDUAL CAMP II Overnight $265

□ INDIVIDUAL CAMP II Commuter $225

□ ELITE POSITION CAMP Overnight $120

□ ELITE POSITION CAMP Commuter $100

□ TEAM SHOOT-OUT (team fee) $225

______________________________________________________ Name

______________________________________________________ E-mail Address

______________________________________________________ Mailing Address

______________________________________________________ City, State, ZIP

______________________________________________________ Phone # Age

______________________________________________________ Grade Entering ’12 School Name

______________________________________________________ Roommate Preference (for overnight campers only)

Height ________ Position (circle): Point Guard Guard Forward Post

T-shirt (circle): YS YM YL AS AM AL AXL AXXL

Enclosed is my $ _________ check or charge $ __________ to the following

(choose one): M/C_______ Visa ________ Exp. Date _______________

Account #: ______________________________________________

Signature of Cardholder: ____________________________________

Print Cardholder’s Name: ___________________________________

Emergency Contact Information

_______________________________________________________ Emergency Contact Relationship

_______________________________________________________ Cell # Home # Work #

EARLY REGISTRATION IS ENCOURAGED AS SESSION ENROLLMENTS ARE LIMITED.

MEDICA L RELEASE & HEALTH I N F O R MAT I ON

If this information is not sent in with the Registration Form and payment, PLEASE COMPLETE THE BELOW INFORMATION AND FAX TO

SHANA KENT AT (662) 915-7871 PRIOR TO THE FIRST DAY OF CAMP.

________________________________________________________ Camper’s Full Name

________________________________________________________ Date of Birth Social Security #

________________________________________________________ Parent / Guardian Name

________________________________________________________ Cell # Home # Work #

I give permission for The University of Mississippi medical personnel to administer first aid and/or to provide the appropriate transportation to a medical facility to receive adequate medical care in the event of any injury or illness.

________________________________________________________ Parent / Guardian’s Signature Date .

INDEMNITY WAIVER I hereby request that you accept this registrant for the Ole Miss sports camp during the dates set forth in this application. I hereby release The University of Mississippi and all of its employees from any claims on account of injuries that may be sustained by the participant while attending this Ole Miss sports camp. In doing so, I acknowledge that I do not have to sign this release and indemnity in order for my child to participate in the camp.

________________________________________________________ Parent / Guardian’s Signature Date .

MEDICAL RELEASE Must be completed by a physician or send a copy of a physical dated no more than 1 year ago.* I have examined the camper named above on this form and found the camper to be free from injuries or conditions that would limit participation in athletics. I recommend that this person be accepted for this Ole Miss Sports Camp.

________________________________________________________ Physician’s Name Phone #

________________________________________________________ Address

________________________________________________________ Allergies

________________________________________________________ Previous Injuries and/or Other Important Health Information

________________________________________________________ Physician’s Signature Date *A copy of a sports’ physical within one year of the date of camp being attended may be substituted for a physician’s signature. This information is confidential and will be retained as a part of each camper’s record.

INSURANCE In order to attend camp, each participant must have insurance coverage and all forms complete at time of registration. Each camper will be covered under a secondary insurance policy, with limited benefits, that is provided by The University of Mississippi. Please note if camper is injured, policy requires a $100 deductible be paid by camper. If a camper is injured, the parent/guardian will be requested to work with officials of The University of Mississippi’s Athletics Department to provide the proper information regarding the injury to the secondary insurance provider. Please include camper’s current health insurance below.

________________________________________________________ Insurance Company’s Name

________________________________________________________ Policy # or Group #

________________________________________________________ Policyholder’s Name Social Security #

Ole Miss Women’s Basketball Camps Attn: Shana Kent 36 Hill Drive - BPF

University, MS 38677

CH

ECK

THE

CA

MP

FOR

W

HIC

H Y

OU

ARE

REG

ISTE

RIN

G!

* OLE M ISS FA CULTY/STAFF RECEIVE A 10 PERCENT DISCOU NT

REGISTER ONLINE @ WWW.OLEMISSWOMENSBASKETBALLCAMPS.COM

N E W S T A F F . N E W A T T I T U D E . N E W E X C I T E M E N T .

T H E

CAMP FACTS

location … Camp is held on the campus of the University of Mississippi in Oxford. Campers must arrive on the day of check-in and depart on the day of check-out. facilities … Tad Smith Coliseum is the hub for all of our camps, with auxiliary gyms located in the BPF, Gillom Center and Turner Center on campus. All campers are escorted by staff to their gyms. Teams must provide their own transportation.

housing … Campers stay at an Ole Miss residence hall located on the Ole Miss campus, just a convenient short walk to and from our camp gyms.

camp fees … Balance due two weeks prior to the first day of camp. Make all checks, money orders and cashier checks payable to Ole Miss Women’s Basketball Camp. No checks accepted the day of registration.

NEW

FACULTY/STAFF RECEIVE A 10 PERCENT DISCOUNT Camps are open to any and all entrants.

(limited only by number, age, grade level and/or gender)

A D R I A N W I G G I N S , H E A D C O A C H B R E T T F R A N K , A S S O C I A T E H E A D C O A C H

K E N Y A L A N D E R S , A S S I S T A N T C O A C H R E B E C C A T A Y L O R , A S S I S T A N T C O A C H