Spring Lake Heights Municipal Recreation Commission presents: The Original Summer Jersey Shore Basketball Camp 2009 The SLH Municipal Recreation Commission Jersey Shore Basketball Camp gives participants the opportunity to become better basketball players in a fun-filled atmosphere. The camp emphasizes defensive and offensive techniques and fundamentals, with plenty of play, drills to help you improve and which you can practice at home, and special emphasis on shooting and ball-handling. Each week, trophies and prizes awarded. Date: July 20 through July 24 Level: Ages 8 through 12 Time: Location: 5:00 PM to 8:00 PM SLH Elementary School Date: July 27 through July 31 Level: Ages 12 through 16 Cost per week: $100.00 residents $115.00 non-residents Instructor: SLH Summer Recreation Coordinator Shawn Heeter, assisted by David Vadas SPECIAL GUEST INSTRUCTOR: ELWOOD MALICK Name:___________________________________________________________________________ Address:_________________________________________________________________________ Phone: ____________________________ E-Mail: _______________________________________ Date of Birth (if under age 18): ___________ Grade (Sept. 2009):_________________________ Emergency Contact (Name and Phone): _____________________________________________________ Select Week: __________ July 20 – 24, Ages 8 to 12 ________ July 27 – 31, Ages 12 to 16 Make checks payable to: SLH RECREATION TRUST FUND Mail check or drop off SLH Borough Hall payment to: 555 Brighton Avenue Spring Lake Heights, NJ 07762 Questions: Richard Diver, Chair, SLH Recreation Commission 732-343-4122 Acknowledgement of Risk – Waiver and Release of All Claims I certify that my child’s current physical condition is satisfactory for participating in the Jersey Shore Basketball Camp program. I recognize and acknowledge that there are certain risks of injury in any recreational program and I hereby assume full responsibility for any expenses incurred as a result of my child’s participation in the Jersey Shore Basketball Camp program. I agree to: (a.) waive and relinquish; (b.) fully release and discharge; and (c.) indemnify and hold harmless the Borough of Spring Lake Heights, commissions, committees, officers, agents and employees, from and against any and all claims for injuries, damages or losses which may have accrued or which may accrue to my child or me on account of my child’s participation in the Jersey Shore Basketball Camp programs. Parent’s or Guardian’s Signature:_______________________________________________________________Date:_______________________