Tom Bryant Memorial Basketball Camp Nov. 5 & 12

The Tom Bryant Memorial Basketball Camp, for boys and girls in grades kindergarten through sixth grade, will be held on Sundays, November 5 and 12.

The camp will be held at St. Anthony Grade School. Kindergarten through second grade will be held from 12:15-2 p.m. and third through sixth grades will be held 2:15-4 p.m.to The entry fee is $30 in advance or $35 the day of the camp.

Instructors will be St. Anthony coaches and St. Anthony players, boys and girls.

All schools are welcome.

Fill out this portion and mail it with your check (payable to the Tom Bryant Scholarship Fund) to: Tom Bryant Scholarship Fund, 912 Oakcrest Drive, Effingham, IL 62401. If there are any questions, contact Anita Baker at 217-663-5061. All funds will be used for the annual Tom Bryant scholarships.

                                                                                 CAMP BLANK

Student Name________________________________________________________

Grade: (Circle one):        K        1        2        3        4        5        6

T-shirt size (Circle one)      YS (6-8)    YM (10-12)   YL (14-16)   AS    AM    AL    AXL

I hereby authorize the staff of the camp to act for me according to their best judgment in any emergency that requires medical attention, and I hereby waive and release the camp from any and all liability for any injuries or illness occurred while at camp. I have no knowledge of any physical impairment that would be affected by the above camper's participation in the camp program.

PARENT'S SIGNATURE _________________________________

PHONE NO.___________________________________________

DATE ________________________________________________