Mississippi State does not discriminate on the basis of race, color, religion, national origin, sex, sexual orientation, or group affiliation, age, disability, or veteran status. Per NCAA rules, sports camps are open to any and all entrants (limited only by number, age or grade level, or gender).

WHAT TO BRING CHECKLIST■ Gym shorts (1–2 per day)■ T-shirts (1–2 per day)■ Athletic socks (1–2 pair per day)■ Basketball shoes■ Protective gear (ankle & knee braces, etc.)■ 2 sheets and a blanket or sleeping bag (twin XL bed)■ Pillow and pillow case■ Towels and washcloths■ Personal/toiletry items■ Money for camp store (Bulldog shirts, shorts, & snacks)■ Current school physical & parental constent form

ROOM AND BOARDResident campers will be housed in double occupancy, on-campus dorms within walking distance to Humphrey Coliseum and Mize Pavilion. Supervision will be provided while dorms are occupied by campers. All meals will be served at Mize Pavilion.

IMPORTANT: Prior to camp, all campers MUST provide a completed “Release of Legal Rights” form and school physical dated within ONE YEAR of the camp start date.

To register for camp, please mail the application along with a $50.00 non-refundable deposit to Mississippi State Women’s Basketball Camp, P. O. Box 5327, Mississippi State, MS 39762, or register online at hailstate.com/camps.

Make checks or money order payable to Mississippi State Women’s Basketball Camps 2017. ** Please put name of camper on check memo line!**Payment is due in full seven (7) days prior to camp start date. Upon receipt of deposit and application, you will receive a confirmation email with registration information.

CAMP CONTACTMaryann Bakermbaker@athletics.msstate.eduPhone: 662-325-8668Fax: 662-325-6801

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2017WOMEN'S

BASKETBALL CAMPS

RELEASE OF LEGAL RIGHTS I hereby give permission for the Camper named above to attend and participate in the Mississippi State University Women’s Basketball Camp. I understand that there are inherent risks and hazards associated with Camper’s participation in the Program, and I hereby give my voluntary consent for the Camper to participate fully in all camp activities. I voluntarily assume full responsibility for any risk of loss, property damage or personal injury, including death, which may be sustained by Camper as a result of Camper’s participation in the Program or while in, on, or upon the premises of where the Program is being conducted or while in transit to or from. In consideration for the right of the camper to participate in this Program, I, on behalf of Camper, myself, and Camper’s heirs, assigns, and personal representative(s) hereby covenant not to sue and further release, waive, and discharge MSU, the Board of Trustees of State Institutions of Higher Learning, and their trustees, officers, agents, employees and volunteers from any and all liability, claims, demands, causes of action arising out of or related to any loss, damage or injury, including death, sustained by Camper or Camper’s property arising out of Camper’s participation in the Program, whether caused by the negligence of or breach of any expressed or implied contract by MSU. If at any time it is necessary for the camper to receive medical attention, I hereby give my consent to the camp to secure those services and arrange transportation if deemed necessary. I am aware that I will be responsible for all medical expenses resulting from any illness or injury. IN SIGNING THIS RELEASE, I ACKNOWLEDGE AND REPRESENT THAT I have read this document, I understand it, I sign it voluntarily, and no oral or written representations or statements of inducements, apart from the foregoing written agreement, have been made.

Parent/Guardian Name (Please Print):

Parent/Guardian Signature:

Medical/Health Insurance Company:

Policy No:

Does the applicant have any history of a physical or medical condition which may affect her ability to participate in the full activities of the camp? YES NOIf yes, please list:

Is applicant taking any medications? YES NOIf yes, please list:

PARENT/GUARDIAN STATEMENT In order to participate in the Mississippi State Women’s Basketball Camp, each camper must have undergone a physical exam within the last 12 months from the initial date of the camp she plans to attend. If she was required to take a physical exam in order to participate on her middle school or high school team during the 2016-2017 school year, then a copy of that physical will suffice. (Include a copy of the camper’s school physical exam with the completed camp application.) Otherwise, the form below must be completed and signed by a licensed medical doctor and returned with the completed camp application.

PHYSICIAN’S STATEMENT I hereby certify that I have examined (Name of Camper) and found her physically fit to attend and participate in the Mississippi State University Women’s Basketball Camp, and I know of no impairments which would limit her participation in all activities in the camp.

Date Examined:

Physician Name (Please Print):

Physician Signature:

Address:

Telephone:

SKILLS CAMP JUNE 4–6 | GRADES 5–12All campers will receive personalized instruction and coaching from Coach Vic Schaefer and his staff. Everything from individual stations, position work, and shooting, to fast break, team practice, and games will be covered—a great way to develop your total game! Fee includes camp T-shirt, camp ball, housing (if resident), and meals.

DAY CAMP JUNE 12–15 | GRADES 2–7Day camp is geared toward the development of fundamental skills for the young and aspiring basketball player. Daily instruction along with fun competition provides the perfect balance for the younger camper. Fee includes camp T-shirt, camp ball, and pizza party on final day.

TEAM SHOOT-OUT CAMPSJUNE 16 / JUNE 17 | 3-GAMES-A-DAY GUARANTEEShoot-out camp is a great way for teams to begin preparing for a championship season. Three games in one day provide the opportunity for frequent, quality competition. Fee includes three-game guarantee, camp T-shirt for 12 players & two coaches, and instruction by camp staff.

Please email wbkcamp@athletics.msstate.edu for separate application and forms.

CAMP FEATURES➤Individual, Fundamental Instruction➤5-on-5, 3-on-3, and 1-on-1 Games➤Free Throw & Shooting Competitions➤Skills Competitions➤Personal interaction with MSU coaching staff and players

FACILITIESAll camps will be held on the Mississippi State Campus in Humphrey Coliseum and the state-of-the-art Mize Pavilion Practice Facility. A certified athletic trainer & training room will be available in all facilities.

CAMP STAFFThis years camp staff will include current & former Mississippi State women’s basketball players as well as your Hail State Hoops coaching staff!

PHOTOGRAPHY RELEASE I give Mississippi State University permission to use photographs taken of (Name of Camper) during the camp to market, promote, and publicize future Mississippi State Women’s Basketball Camps.

Parent/Guardian Name (Please Print):

Parent/Guardian Signature:

Please check events participating in below:

■SKILLS CAMP June 4–6 | Grades 5-12 ■ $275 Resident ■ $200 Commuter

■DAY CAMP June 12–15 | Grades 2–7 | $65

■TEAM SHOOT-OUT CAMPS June 16 and/or 17 | $250/team Includes 12 players & 2 coaches; $25 for each additional player/coach. Email wbkcamp@athletics.msstate.edu for separate application and forms.

2017 WOMEN'SBASKETBALL CAMPS

CAMPER NAME

ADDRESS

CITY STATE ZIP

( ) — CELL PHONE

DATE OF BIRTH AGE GRADE IN FALL OF 2017

T-SHIRT SIZE (circle one):

YS YM YL AS AM AL AXL A2XL A3XL

ROOMMATE PREFERENCE

NAME OF PARENT(S)/GUARDIAN(S)

( ) — ( ) — HOME PHONE CELL PHONE

E-MAIL ADDRESS (All confirmation/registration information will be sent to this address.)

EMERGENCY CONTACT (other than parent or guardian)

( ) — EMERGENCY PHONE

I want to personally invite you to

Mississippi State University and our camps

this summer. My staff and I are dedicated

to providing each camper with a fun-filled,

competitive experience. Campers will learn

the fundamentals of the game as well as

be involved in competitive situations on a

daily basis. We invite you to come experience

Mississippi State University, our staff, our

team, and our program. Come experience

“OUR STATE”!

TEAIRAMcCOWANcamp counselor

VICTORIA VIVIANS

camp counselor

MORGAN WILLIAM

camp counselor