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2008 BASKETBALL CAMP REGISTRATION FORM

PLEASE PRINT
Name Grade (08-09) . Address City . State Zip Email .
Phone Cell Phone .
School Date of Birth: . Shirt Size (Please Circle): Youth: S M L Adult: S M L XL
. Parent or Guardian Signature
CHECK CAMP ATTENDING
Mountie Day Camp July 7-10 $65.00
Mountie Day Camp July 14-17 $65.00
High School Basketball June 21 $195.00/
Team Shoot-Out team
High School Basketball June 28 $195.00/
Team Shoot-Out team
Ultimate Scoring Clinic June 30-July 3 $125.00
PLEASE RETURN CAMP REGISTRATION FORM WITH DEPOSIT
If attending the “Ultimate Scoring Clinic” please include a $50 non-refundable deposit. The balance is due at registration.
Checks or money order made payable to Mansfield University Men’s
Basketball.
Credit Card Payments below:
$ Amount to be charged (total amount will be charged
unless amount indicated)
Credit Card # Exp. Date .
Cardholder Signature Date .
Cardholder Name (printed) .
MAIL TO: Coach Rich Miller
Mansfield University
Men’s Basketball Office
Decker Gymnasium 111
Mansfield, Pa 16933

2008 Basketball Camps, Shoot-Outs, and Ultimate Scoring Clinic

Men’s Basketball Office
Decker Gymnasium 111
Mansfield, Pennsylvania 16933

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2008 Mansfield University Basketball Camps, Shoot-Outs & Ultimate Scoring Clinic

Mountie Day Camp July 7 - 10
July 14 - 17
High School Team June 21
Shoot-Out June 28
Ultimate Scoring Clinic June 30 - July 3

CAMPS

Mountie Day Camps
July 7 - 10, M-TH, 9:00AM—12:00PM
July 14 – 17, M-TH, 9:00AM—12:00PM
Boys & Girls entering grades 1-8
Registration Deadline June 26
$65 per camper
The Mountie Day Camps are designed to give young players a fun-filled
atmosphere in the sport of basketball. The camps feature individual
drills to develop offensive and defensive skills. The campers will learn
fundamentals while competing against other campers within their own age
group and ability level. Each camper will receive a free Mansfield Basketball
Camp T-shirt at the conclusion of camp.
High School Shoot-Outs
June 21 & June 28
Registration Deadline – June 17
$195 per team
The High School Shoot-outs are a great way to get your team ready for
their summer league schedule, and a great way to get a jump on the
competition going into next season. All teams will be guaranteed
three games against similar competition in a round robin format.
Ultimate Scoring Clinic
June 30– July 3, M-Thu, 9:00AM – 4:00PM
Boys entering grades 3 – 12
Registration Deadline July 3
$125 per camper (includes meals and free t-shirt)
The Mountie Ultimate Scoring Clinic is designed to teach campers
techniques to become a more proficient scorer in the game of
basketball. Each camper will have instruction on ways to improve his
ability to score at all levels. Drills on ball, handling, one on one moves,
shooting technique, and individual practice methods will be stressed.
Each camper will have an opportunity to compete for shooting and
individual offensive awards within their own age and ability levels.

COACHING STAFF

RICH MILLER
Camp Director
Head Basketball Coach
Coach Miller will be leading the Mounties for a fourth season in 2008-09 after serving as an assistant coach for six years. He played one year on the 1997-98 Mountie team and was twice named PSAC East rookie of the week. In his first season as the Head Coach at Mansfield , Miller guided the Mounties to a 2nd place finish in the PSAC East and a spot in the PSAC Final Four. Coach Miller came to Mansfield after graduating from Bucknell University, where he played basketball and football. The Mounties averaged 15 wins over the last 4 years, while winning the ECAC championship in 2003, and the PSAC Eastern Division championship in 2005. Coach Miller has vast experience in directing basketball camps. Penn State and the University of North Carolina’s summer camps are among the many camps he has worked during his coaching career. His desire to help young players develop their skills in basketball makes this camp one of the best in the east.

JASON MATTERN
Assistant Camp Director
Assistant Basketball Coach
Coach Mattern will be starting his fourth season as the assistant coach at Mansfield University. He is an outstanding instructor on the fundamentals of basketball. Coach Mattern enjoyed a stellar three year career as a player at Mansfield where he served as team captain and an outstanding guard on two PSAC playoff teams. Prior to playing at Mansfield, Coach Mattern played one season at Penn College where he drained 125 three point shots in 25 games.
He is interested in helping the guards develop their skills and work on the correct shooting form. Coach Mattern was a PSAC and MU Presidential Scholar Athlete.
FOR MORE INFORMATION
OR ADDITIONAL BROCHURES:
Rich Miller – Head Coach
570-662-4862 crmiller@mansfield.edu
Jason Mattern – Assistant Coach
570-662-4453 jmattern@mansfield.edu

GENERAL INFORMATION

Facilities
Instruction and recreational activity will take place in the Kelchner Fitness Center and Decker Gymnasium – home of the Mountaineers. The complex has three basketball courts, a swimming pool, a weight room, locker & shower facilities.
Meals
Mansfield University offers each camper one of the most modern and complete dining facilities in the northeast. Campers will enjoy the meals with a choice of nutritious entrees at each meal, as well as a soup & salad bar. Our menu is all-you-can-eat with a full dessert and ice cream bar.
Location
Mansfield University is located on Route 6 and Route 15 in the borough of Mansfield. We can easily be reached by interstate 80 in PA. We are 45 minutes north of Williamsport on Route 15; and 30 minutes south of Corning, NY on route 15.

University Policies
The university does not provide medical insurance for campers. In the event of illness or injury requiring treatment, hospitalization, or surgery, family medical insurance must be used.
Cancellation Policy
The university may cancel or postpone any camp because of insufficient enrollment or other unforeseen circumstances. If a camp is cancelled or postponed, the university will refund registration fees.
NCAA Rules and Regulations
In accordance with NCAA rules and regulations, “senior prospective student-athletes” shall not be permitted to be employed in an institution’s summer sports camp. Institutional staff members or representatives of its athletics interest shall not employ or give free or reduced admission privileges to a high school, preparatory school, or two year college athletics winner. A member institution may not compensate or reimburse a high school, preparatory school, or two year college coach based on the number of campers the coach sends to camp.

INFORMED CONSENT RELEASE & EXPRESS ASSUMPTION OF RISK FORM
I realize that injuries can be a consequence of participating in this activity and no amount of reasonable supervision or use of the facilities will prevent injury. I appreciate the character of the risk involved and I voluntarily assume on behalf of my child all risk of possible harm or injury in participating in this designated activity (basketball). I have carefully considered how the possible consequences of injury may impact my child’s life, and I choose to accept this risk and allow my child to participate in the designated activity (basketball).
In accepting this risk, I expressly and explicitly release, discharge and waive any and all responsibility of Mansfield University of Pennsylvania’s State System of Higher Education, the Commonwealth of Pennsylvania, and the employees, officials, or agents of any and all of the foregoing, pursuant to, and pertaining or relating to, or arising from, in any matter, injuries to my child as a result of my child’s participation in this activity (basketball).
I give my permission to Mansfield University Public Relations Office to use my child’s photo/video image in various print or broadcast media to promote Mansfield University. Media outlets may include, but are not limited to, print ads, television ads, billboards, and movie theatre ads.
By my signature below, I certify that I completely understand this document. I certify that I am eighteen years of age or older, and I am not under the influence of any drugs or alcohol.
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Signature of Parent or Guardian Date
2008 MEDICAL INFORMATION & AUTHORIZATION FORM
(all campers must provide proof of insurance coverage)
All campers must provide proof of insurance coverage that will cover any medical costs in the case of an injury. Mansfield University and Mountie Basketball Camps do not assume financial responsibility for any medical expenses in the case of an injury. No special physicals are necessary to attend the camp.
Insurance Company: .
Policy: Certificate # (if applicable): .
PERTINENT MEDICAL HISTORY
Date of last Tetanus Shot: .
Prescribed Medications: .
Any allergies or significant injuries: .
MEDICAL AUTHORIZATION STATEMENT
As a parent / guardian of , I do hereby authorize physicians or other medical personnel permission to treat my son/daughter for an accident, injury, or illness. In case of emergency, my work # is , my cell # is .
If I cannot be contacted, please contact the following:
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Contact Person Phone Number Relationship
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Signature of Parent or Guardian Date
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Name of Parent or Guardian (please print) Date