Head Start Basketball Camps


	Print the registration form on your printer and send it to the address on the form.


	Registration Form - HEAD START BASKETBALL CAMP Highland Heights , OH - Summer 2010/ Boys and Girls, grades 1-6


	Name___________________________________Phone Number________________ Address_____________________ City __________________Zip Code__________ Grade _____School Attended_______________ Email Address________________ June 14-18, St. Paschal Baylon School - (1:30 p.m. - 4:30 p.m.) I, the undersigned (parent or guardian) do hearby release and waive any and all rights and claims I may have against Head Start Basketball, Inc., its shareholders, employees, and the Richmond Heights Local Schools regarding injuries suffered by my son or daughter while enrolled in the HEAD START BASKETBALL CAMP. Parent or Guardian signature _________________________________________________________Date__________________________ The cost to enroll in the HEAD START BASKETBALL CAMPS is $60. Please make check or money order payable to Head Start Basketball, Inc. and send to Head Start Basketball, Inc., 12017 The Bluffs, Strongsville, OH 44136. For more information call (440) 268-0457.