1. sports
2. basketball

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Maple City Baptist Church is excited to be hosting their 6th Annual MC Hoops
Basketball Camp. All children will receive a camp T-shirt and basketball!
DATES:
July 20-24, 2015
TIME:
9:00 a.m. to 3:00 p.m. daily
COST:
$110.00 (second child: $80; third+: $60)
Each group will be open to the first 30 children who register.
GROUPS (Based on September, 2015 School Enrolment):
JUMP BALL:
Children entering Grades 2 - 4 (location – TBA)
FAST BREAK:
Children entering Grades 5 - 6 (location – TBA)
SLAM DUNK:
Children entering Grades 7 - 9 (location – TBA)
(Your child will be assessed and, based on their skills, may be moved to a higher level.)
Each group will receive basketball instruction according to their age and skill level.
Each day the children will be taught a lesson about Jesus from the Bible.
If you would like to register, please fill out the camp registration form and drop it
off or send it to 500 Indian Creek Road West, Chatham, ON, N7M 0P4
Online registration forms available at: www.mchoops.com
Payment can be made via PayPal online at www.mchoops.com; by e-transfer to
dchristiaans@maplecitybaptistchurch.com; by sending a cheque; or bring cash
or cheque to the church office (500 Indian Creek Rd. W. N7M 0P4, Chatham)
(Please make cheques payable to: Maple City Baptist Church)
Camp week will conclude with an awards presentation at
Chatham-Kent Secondary School.
If you have any questions, please call the church office at 519-351-2004.
Email: dchristiaans@maplecitybaptistchurch.com
* PLEASE KEEP THIS PAGE FOR YOUR RECORDS
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MC HOOPS PARTICIPANT REGISTRATION FORM 2015
Child’s Name
Date of Birth
Male
Female
Address
Postal Code
Email Address
Grade in
September 2015
T-Shirt Size
(Please circle correct size):
YOUTH:
Small
Medium
Large
ADULT:
Small
Medium
Large
PARENTAL CONTACT(S)/LEGAL GUARDIAN(S)
Name
Relationship
Phone Numbers:
Home
Work
Cell
Name
Relationship
Phone Numbers:
Home
Work
Cell
SECONDARY EMERGENCY CONTACT
Name
Relationship
Phone Numbers
Home
Work
Cell
I am the legal guardian of the child with full authority to make decisions with respect to the child. I confirm
that the people listed above have my full authority to pick up my child during, or at the end of, the session;
and I hereby authorize you to release the child into the custody of any of the above people. By signing this
form, I hereby give permission for my child to attend MC Hoops Camp.
Signature of Parent/Guardian
Date
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MEDICAL INFORMATION FORM
Doctor’s Name:
Phone:
Does your child require:
Glasses
Contacts
Hearing Aid
Inhaler
EpiPen
(If your child requires an EpiPen, he/she must have it with them at all times.)
List any allergies below:
Please note the usual treatment of these allergies:
If your child has any other medical conditions, please list:
Is there anything else you would like us to be aware of?
PAST BASKETBALL EXPERIENCE (please circle):
Have you played basketball for a school team?
YES
NO
Have you played OBA?
YES
NO
Is this your first time at MC Hoops Basketball Camp?
YES
NO
*Please send completed registration form with full payment to Maple City Baptist Church at 500 Indian
Creek Rd. W. Chatham, ON. N7M 0P4. Please make cheques payable to Maple City Baptist Church.
For your convenience, payment can be made online via PayPal at: www.mchoops.com