Wufoo

Application Form

THE JARVIS HAYES FOUNDATION BASKETBALL SKILLS CAMP
Girls and boys 6 years old (at time of camp) or older who have not entered into the 9th grade

Camper/Age as of Camp Date
Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Contact Name First Last
Phone Number ### - ### - ####
Emergency Phone Number ### - ### - ####
Email Address
Position - VERY IMPORTANT - Check all that apply!
Point Guard Shooting Guard Small Forward Power Forward Center
T-shirt Size (ADULT)
Insurance Carrier/ID#
Payment Method (1 PLAYER FEE: $175 or $150 if registered by June 15) If paying by credit card, please contact Tami Goodwin at 678.754.3239.

Please make checks payable to “The Jarvis Hayes
Foundation”, sign the application, include the $75
non-refundable, non-transferable deposit and mail to:
The Jarvis Hayes Foundation
Basketball Skills Camp
3535 Peachtree Road
Suite 520-221
Atlanta, Georgia 30326
Do Not Fill This Out