Lady Pilgrims Basketball Image
Plymouth Lady Pilgrims Youth Basketball Camp on May 14-17, 2018
SCHEDULE Auxiliary Gym
5:15-6:15 p.m. - Kindergarten, 1st Grade , 2nd Grade, and 3rd Grade
6:15-7:15 p.m. - 4th Grade , 5th Grade, 6th Grade & 7th Grade
Note that grade levels are based on current 2017-2018 school year.
COST: $45 per camper
$30.00 for each additional sibling
Checks made out to: Plymouth High School
**Each Camper will receive a Lady Pilgrims basketball AND camp t-shirt!!
ENROLLMENT: Please fill out the form below and return to:
Brandi Sullivan
11928 Ridgeview Dr. (or your school office or bring to first day of camp)
Plymouth, IN 46563
EMPHASIS: Fundamental skills development, teamwork, sportsmanship, and effort.
Camper’s Name: ______________________________________ Grade Level: ___________
School: ______________________________________________________________________
T-Shirt Size: (Select one)
Child 10/12 14/16
Adult S M L XL
Parent/Guardian: ______________________________________________________________
Address: ______________________________________________________________________
Phone : _______________________________________________________________________
Email: ________________________________________________________________________
I give permission _________________________(student) to participate in (name of activity). I agree to
release and hold harmless the Plymouth Community School Corporation, its employees and agents from
any liability for damages or injuries suffered during the student’s participation in (name of activity). I
further authorize the Plymouth Community School Corporation, its employees and agents to seek, obtain
and approve necessary medical treatment for the student while participating in (name of activity). I agree
that I am responsible for the cost of any medical treatment provided for the student.
Parent or Guardian:______________________________________Date:_____________
Plymouth Lady Pilgrims Youth Basketball Camp Form as a PDF
Plymouth Lady Pilgrims Youth Basketball Camp Form as a Word Document
