Application

Mail application, along with non-refundable deposit to:

 

Basketball Camp Director

Lyon College

P.O. Box 2317

Batesville, AR 72503

Make checks payable to Lyon College

 

                *****Please Print*****

   May 31 - June 3 - Elementary Boys & Girls Day Camper

   June 6-9 - Middle School Boys & Girls Day Camper

   June 12-15 - Jr.-Sr. Boys

   June 26-29 - Jr.-Sr. Girls

Deposit Enclosed (please check one)

   $25.00 Day Camper

   $50.00 Jr.-Sr. Resident Camper

   $50.00 Commuter Camper (non-resident)

 

Name__________________________________________________

Address________________________________________________

City & State_____________________________________________

Zip_______________ Grade (next year)_______________________

Telephone: (Home)________________________________________

        (Emergency)_________________________________________

T-Shirt Size (circle one)      S        M        L        XL

Height___________   Position (circle one)      G        F        C

School_________________________________________________

Parents_________________________________________________

Roommate     1) __________________________________________

                      2) __________________________________________