Minnesota Elite Basketball Camp
2010 Minnesota Elite Girls Basketball Camp:
June 28-30 @ Concordia University-St. Paul
Home
2010 Interested Players
Girls Application
2009 Daily Schedule
Insurance Form
Minnesota Elite Girls
Minnesota Elite Boys
Elite Camp Alumni
Nomination Form
Colleges Attending
Insurance Form
*Name
*Address
*City/State/Zip
*Phone Number
*Birthdate
*School
*Insurance Company
*Insurance Policy Number
*Emergency Contact Name
*Relation
*Home Phone
*Cell Phone
*Emergency Contact Name
*Relation
*Home Phone
*Cell Phone
*Family Physician
*Grade in Fall of 2009
*Other Sports
Have you now or have you ever had any of the following
*Heart Disease
Yes
No
*Family History of Heart Disease
Yes
No
*Recurrent Illness
Yes
No
*Allergies
Yes
No
*Asthma
Yes
No
*Epileptic
Yes
No
*Mononucleosis
Yes
No
*Absense of Paired Organ
Yes
No
*Head Injury
Yes
No
*Neck Injury
Yes
No
*Unconsicious
Yes
No
*Taking Prescribed Meds
Yes
No
*Shoulder Dislocation
Yes
No
*Shoulder Seperation
Yes
No
*Low Back Injury
Yes
No
*Knee Injury
Yes
No
*Thigh Injury
Yes
No
*Ankle Injury
Yes
No
*Fractures
Yes
No
*Muscle Pulls
Yes
No
*Surgery
Yes
No
*Wear Visual Aids
Yes
No
*Wear Dental Appliance
Yes
No
Explain any yes answer from abouve
*Date of Last Tetanus Shot