2009 MCLA Boys Basketball Camp

IMPORTANT: By filling out the form below, you are only holding a spot in camp. During registration, you will need to bring a signed permission form and the registration payment.

Name:

Birthday:

Address:

City:

State:

Zip:

email address:

Phone:

School:

Grade entering:

Insurance Company:

Policy #:

Emergency Contact:

Phone:


Day Camp at MCLA:
June 29 - July 2.
9:00 am - 2:30 pm ($80 Tuition)
Boys entering grade 6-12 in the Fall of 2009

Registration deadline is June 24, 2009

Payment is due in full with the registration form.

Please include on a separate sheet any medical immunizations, allergies, and medication.

Please make checks out to MCLA Basketball. They can be dropped off at MCLA athletic department or mailed to MCLA Basketball 375 Church Street, North Adams, MA 01247.
For further information contact 413-662-5352 or 413-662-5411 during the hours of 8am till 4pm