REGISTRATION Detach and Return with check or money order in the amount of $115.00 per week registered to: Samuel L Gravely,Jr 4670 Waverly Farm Drive Haymarket, VA. 20136 Camper Name:___________________ Age____ Grade entering______ Address ________________________________ Home Phone Parent Name Parent Work/Cell Phone___________ Our daily sports will be selected based on the weather forecast for the day, to ensure we have an activity every day of camp. Below is a general listing of sports and some details of activities we will include. Basketball Conditioning and drills Scrimmages and game play Shooting contest Gravely Multi-Sport Summer Camp 2015 Soccer Conditioning and drills Scrimmages and game play Boys and Girls Entering Grades 1-6 Flag Football Conditioning and drills Scrimmages and game play Punt, pass and kick contests 3 Sessions Available Session A - June 22-26 Session B – June 29-July 3 Session C – July 6-10 School attend ________________ Parent email address, please print clearly! ________________________________ T-Shirt Size: Youth: YM YL Adult: M S L XL Please Check Session(s) you are registering for: Session A June 22-26 Session B June 29-July 3 Session C July 6-10 __________ ___________ ___________ Volleyball Skills and drills Game play Large oversized ball use/ fun game match Floor Hockey Skills and drills Game play Gravely Elementary School 9am-12pm This multi-sport camp will provide a wide range of sports, conditioning and skill training specific to the sports we focus on each day. The emphasis is on FUN and instruction. The camp is designed for children entering grades 1- 6th. Our daily sports will be flexible based on the weather, each day of camp may include: basketball, soccer, flag football, volleyball, and floor hockey. SCHEDULE WHAT: This multi-sport camp will provide a wide range of sports and skills training specific to the sports we focus on each day. Session A - Mon-Fri June 22-26 Session B - Mon-Fri June 29-July 3 Session C - Mon -Fri July 6-10 PERMISSION I give permission for my child(ren), ______, to WHO: Students entering grades 1-6 WHY: Providing a multi-sport camp will allow us the flexibility to offer our camp no matter what the weather brings each day. WHERE: Samuel L Gravely Elementary 4670 Waverly Farm Drive Haymarket VA. 20169 participate in the Gravely Multi-Sport Daily Schedule: Camp. I have notified the staff of any 9:00-9:15am Arrival 9:15-9:45am Skill Development REGISTRATION Max. 50 campers accepted for all sessions weekly. Sessions fill up quickly, don’t delay. COST: $115.00 per week covers facilities, use of equipment, 15hrs/per week of instruction, t-shirt and snack. NOTE You will only be contacted if a session that you have registered for is full. In this case we will ask if you would like another session or refund your check. Camp Director: Anthony Klisiewicz, (Mr.K) For more information call 703.400.6891 or email [email protected] I understand that sports participation is a strenuous activity and will not hold 9:45-10:15am Scrimmage/Game 10:15-10:30am Break/Snack 10:30-11:00am Skill Development 11:00-11:30am Scrimmage/Game 11:30-12:00pm Review/Pick up WHEN: 3 Sessions available: **IMPORTANT PLEASE READ** medical conditions and concerns. Prince William County Schools, Samuel L Gravely School, or any staff members responsible for injuries that may occur through normal participation. My child has been instructed to dress appropriately, wear supportive shoes, and rest and drink water as needed. I Please Bring: Cool, Comfortable clothes. Athletic shoes Water Bottle (water and cups are always available) will pick my child up on time, 12:00pm. Parent Name . Parent Signature . All equipment provided. ** Please make camp director aware of any special medical concerns or medication needs. Please call with any questions.
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