cut here > -------------------------------------------------------------------------------------------------------

I am sending my tuition fee to reserve my spot and register for the Bob Cantu Fundamental Basketball Camp.

___ $125    ___  $125(Additional Child or Multi-Camp)  

Sess 1____  Sess 2____  Advanced Skills Camp____  Sess 3____  Sess 4_____ 

Name______________________________  Age_______  School_________________________  Grade_______

Address__________________________________  City_____________________  State_______  Zip_________

Parent’s Name_______________________________  Telephone________________  Email_________________

Method of Payment (circle one):        Check          Visa          MasterCard

Credit Card #_________________________   Expiration Date______________

I, the undersigned, acknowledge that Bob Cantu and the Fundamental Basketball Camp merely sponsor the above-named activity and realize that no medical insurance is provided. I assume all risks and hazards thereto, including those arising in course of transportation to and from the location and hold any of its employees, and volunteer personnel harmless from any claims or illness arising out of or in any way connected with the above-mentioned activity.

Signature of Parent or Guardian___________________________________________  Date_______________

Make check payable to: Fundamental Basketball Camp     Send to: Bob Cantu PO Box 13106 San Luis Obispo CA 93406