Registration for Lil Bobcat Basketball Camp

Please fill out the form below to register for Lees-McRae's 2013 Lil' Bobcat Basketball Camp, scheduled for June 19-21. The camp puts an emphasis on instruction in all facets of the game, as well as station work and 3-on-3 competition.

The camp is open to both boys and girls in grades 3-6, and will run from 9 a.m. to 12 p.m. The cost of this camp is $50 per player. Each camper will receive a free T-Shirt.

 Walk-ins welcome - registration begins at 8 a.m. on first day of camp.

For more information, please contact head women's basketball coach Michele Williams by phone at (828) 898-2482, or assistant coach Ryan Riedel by phone at (828) 898-3431 or by email at

Personal Information

Email address *
First name *
Last name *
Address 1
Address 2
ZIP Code
Home Phone
Alternate Phone
Shirt Size *
Covered under Medical Insurance? *
If yes, please specify your provider and policy information in the fields below
Insurance Provider *
Enter N/A if not applicable
Policy Holder Name *
Enter N/A if not applicable
Policy Number *
Enter N/A if not applicable

Custodial Parent/Guardian Information

Registrant is in the custody of
If provided options do not apply, complete the next field
  Both parents
  Mother only
  Father only
Mother/Guardian Name
Daytime Phone
Work Phone
Father/Guardian Name
Daytime Phone
Work Phone

Medical Information

Please list medications *
Please list allergies *
List any known physical limitations or concerns that we should be aware of

Emergency Contact Information (other than guardian)

Full name
Home Address 1
Home Address 2
Primary Phone
Alternate Phone
Relationship to camper

Waiver of Responsibility

I agree Lees-McRae College and its athletic department is released from liability in connection with medical treatment and unavoidable accidents. Lees-McRae College Lil' Basketball Camp also has my permission to use necessary medical measures in the event of an emergency, for which I will be financially responsible.

I fully understand the inherent risks involved in the activities my child will be participating in for this basketball camp at Williams Gymnasium. I accept all risks including those activities preliminary and subsequent to the activity.  

I do hereby further declare [provide child’s full name below] to be physically sound and suffering from no condition, impairment, disease, infirmity, or other illness that would prevent their participation, with or without reasonable accommodation of any disability, in any of the activities and programs of the Lees-McRae College Lil' Bobcat Basketball Camp. I do hereby assume all responsibility for this child’s participation and activities, and his/her use of equipment in activities. *

Also, I give the Lees-McRae College women's basketball program permission to utilize my child's photograph or likeness in camp promotional materials.

Parent or Guardian Electronic Signature *
Date *


Lees-McRae Athletic Camps


Lees-McRae College Lil' Bobcat Basketball Camp
Attn: Michele Williams
PO Box 128
Banner Elk, NC 28604

* = required field