CapitolHoops.com Top 100 Camp Registration 2010
Capitol Hoops LLC
2010 CAMP DATES & INFO
October 30-31, 2010
Washington Bible College , Lanham MD
http://www.capitolhoops.com
Participant Information
First Name
Last Name
Grade
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Birth Date
Sex
M
F
Height
Weight
*
High School
*
City
State
AAU Team
*
Email
Position
M
F
*
Shirt/Jersey Size
Household / Adult Primary Contact
You can choose to have lunch provided for and additional $10 which takes care of food for the camper on both Saturday and Sunday. If you have been given a promo code you can enter it now (below). *** For tax puposes you must select the State in which you currently reside.
*
Choose Your Registration
Registration (no lunch)
Registration (with lunch)
PROMO CODE (If Applicable)
*
Residency (Tax)
Resident of MD
Resident of VA
Other
*
Relationship To Participants
Self
Mother
Father
Guardian
Other
*
Name on Card
*
Credit Card Type
Visa
MasterCard
American Express
Discover
*
Credit Card Number
*
Expiration Date (mm/yy)
*
First Name
*
Last Name
*
Email Address
*
Address 1
Address 2
*
City
*
State
*
Zip
Phone
Alternate Phone
*
By checking below I agree to remove CapitolHoops.com from any liability of injuries that may occur due to participation in the Top 100 Camp.
I AGREE
*
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