Application
Please fill in the form and use the PRINT button below to print the application.
Mail the application with fee payable to:
Mike Gosz - 276 Nob Hill East - Colgate, WI 53017
Phone: (262) 510-5101 - Email:  This e-mail address is being protected from spambots. You need JavaScript enabled to view it  
Personal Information
 
Last:
First:
M.I.
HT.
Address
Miscellaneous
(Fall of 2019)
Gender
T-shirt size
Camps & Fees
June 17-20
Fundamental Camp
@ St. Mary's, Menomonee Falls
First family member: $90.00
Each additional family member: $80.00
June 24-27
Fundamental Camp
@ Hamilton High School, Sussex
First family member: $90.00
Each additional family member: $80.00 
July 8-11
Basketball Academy
@ St. Dominic's, Brookfield
First family member: $185.00
Each additional family member: $165.00
July 16-18
Shooting/Offensive Skills Camp
@ Hamilton High School, Sussex
First family member: $90.00
Each additional family member: $80.00
WaiverI hereby authorize the personnel of the 2019 Mike Gosz Basketball Camp to act for me according to their best judgment in any emergency requiring medical attention.  I hereby release the camp, its affiliates, and all agents from any and all liability for any injuries sustained while at camp.

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Parent or Guardian Signature
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Date