Sign up for Iowa Wesleyan Elite basketball camp

Who: Boys entering grades 9-12 in the fall of 2014 or ages 14-21.Geared for those who have a desire to be pushed by college coaches

When: May 11. Registration begins at 12:30 pm with camp starting at 1:30 pm. Camp will be done by 5:00 pm

Where: Ruble Arena on the campus of Iowa Wesleyan College in Mt. Pleasant, IA

Cost: $30 which includes a T-shirt


Please fill out the attached form and mail, along with a check (payable to Iowa Wesleyan Menâ??s Basketball) to Iowa Wesleyan College, Menâ??s Basketball, 601 N. Main St, Mt. Pleasant, IA 52641. Please call 319-931-8798 or email with any questions.

Name: _________________________________ Parentâ??s Name: ______________________________________________

Address: _________________________________________________ Email Address: ______________________@____________

City: ________________________________ State: ______ Zip: ___________ Phone #: __________________________

Grade Fall 14_____School________________________High School Coach: ____________________ Coaches #:_________________

Parental Statement/Insurance Information Release Form

I authorize the Iowa Wesleyan Menâ??s Basketball Camp/Iowa Wesleyan College to obtain medical care or treatment for the named participant in the event a medical emergency or if a non-emergency treatment is required and I cannot be reached to provide consent. I release Iowa Wesleyan Menâ??s Basketball Camp/Iowa Wesleyan College from all claims resulting from illness, injury, accident sustained by participant thereby permitting participant to take part in the Basketball Camp on the campus of Iowa Wesleyan College.

Signature____________________________________________ Date__________________________________

Courtesy Iowa Wesleyan College