All rights reserved.

                                       
Send registration form to:  
 txgrandne@gmail.com                                  
Texas Prep Basketball School                      
c/o Rene Hoffpauir                                         
229 Bob White Lane                                                      
Anahuac, TX 77514                                            

Camp Tuition:        $36
0.00  Checks payable to:  Texas Prep Basketball School
   
(please print).  
Last Name:
                                       First Name:                                            

Address:                                                                                                                

City:
                                                State:                         Zip:                        

Phone:                                         Alt phone:                                                   

Height:          Weight:           Age:                Sex:______Grade 2011-12:                         

School (name/city):
                                                                                        

valid email address:                                                                                       

Roommate preference: (optional)                                                                 

I hereby authorize the Directors of Texas Prep Basketball School to act for
me according to their best judgement in any emergency requiring medical
attention and I hereby waive and release Texas Prep Basketball School
from any and all liability.

 
                                                                                                                       
  Parent or Guardian Signature                                Camper signature

  Insurance Information:

 
                                                                                                                        
  Medical Insurance Company                                Policy holder’s name

 
                                                
  Policy and Group #
Register by Mail
or online!
$160 deposit
$360 payment in full
$200 balance