CoEd Basketball 2

2007 Boys and Girls Intructional Basketball Camp Application
JUNE 25 to JUNE 29 Mon. to Fri., 9:00am to 2:00pm

Cohocksink R.C., 2901 Cedar St, 19134 (215-685-9884)
Coach Dennis Seddon, Roman Catholic H.S.

Gathers R.C., 25 & Diamond 19121 (215-685-2710);
Coach Rodney Richardson, P.D.R. Staff

Guerin R.C., 16 & Jackson 19145 (215-685-1894);
Coach George Anderson, Southern H.S.

R. Wright R.C., 34 & Haverford 19104 (215-685-7686);
Coach Vincent Smalls, Com. Age Group.

Campers' Information

Campers Name:_____________________________________Age as of June 25:______

Date of Birth:___/__/__

Shirt Size:__Med. __Lg.__X-Lg.__Circle One

Male    Female - Circle One

Parent or Guardian:________________________ Phone Number: (____)___________

Address:_________________________ __Second Phone Number: (____)___________

City:___________________________________State:________Zip Code:___________

Emergency Contact:____________________________Phone Number: (____)_______

Session Requested: _______________________________________________(list site )

Enclose $25.00 money order payable to the site selected to complete registration.

MAIL CAMPER REGISTRATION FORM AND MONEY ORDER TO:

2006 Instructional Basketball Camps
Philadelphia Department of Recreation
1515 Arch St. Rm. 10-151
Phila. Pa. 19102-1587

Camp hours are Mon. to Fri. 9:00am to 2:00pm.

There is no "after care", so arrange accordingly.





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