Spring Elite Spotlight- College Exposure Application-The Big 60
May 21 and/or June 18 at Lancaster Bible College 
(901 Eden Rd, Lancaster, PA 17601
Attention: Early registration deadline for May 21 extended to May 11
 

this is for individual players, not teams-
All games live streamed & placed on YOUtube
8:30 am-3:30 pm

-Check our website- www.pahoops.org -for the team rosters, player numbers and schedule two days before the event.  Players only need arrive a half hour before their first game. 

Players in grades  9, 10, 11. and 12 are eligible to participate. 
Players will be accepted on a first come basis.

 

First Name ____________________________Last Name ________________________________ Gender  _______

Address _______________________________________

City _______________________________              State ________        Zip code   ___________

Print email address  _______________________   Home phone ____________________    Birth date ____________

Height _______  Weight ______                                 Graduation year (circle one)    ____2017    ___2018   ____2019 ____2020    

High School ______________________________________      city__________________________________ state  ______

Parent Consent and Medical Information
(Players cannot participate unless they have medical insurance).-Players cannot participate unless this section has been completed and signed by the parent or guardian. I understand that the Showcase and the host venue does not carry medical or accident insurance for the participants, and I hereby certify that my child is covered by personal insurance or is included in a policy which I have in place. I authorize routine medical care for my child by the Shootout trainer. I further authorize any treatment considered routine to be referred to a local physician or to an emergency room at my expense. I further authorize and provide my consent and permission for my child to participate in this event.

Insurance Company ____________________ Policy _____________ Group # ________

Name of Policy Holder _____________________________ Home Phone __________

Signature of parent/guardian _________________________ Cell phone _____________


Payment choices       Check one: :           ____check           ____ money order         ____ credit card on Pay Pal 

__________

___________   For May 21- $128.00  
Boys Shootout,  early registration- at Lancaster Bible College- late registration May 11  to day of the event $140.00.
___________   For May 21   $128.00   
Girls Shootout,  early registration- at Lancaster Bible College-late registration May 11   to day of the event $140.00.


___________   For June 18- $128.00  Boys Shootout,
  early registration- at Lancaster Bible College- late registration June 3 to day of the event $140.00.
___________   For June 18   $128.00   Girls Shootout,
  early registration- at Lancaster Bible College-late registration June 3  to day of the event $140.00.
  
 

Send your check or money order with your application (Make your check payable to: Bill Gaffey,)  and send your completed application to Bill Gaffey    417 Bolton Drive, Harrisburg, PA   17112 -or pay by credit card on our Pay Pal (click on the BUY NOW button) -

For more information or help-call 717-545-0872 -email wgaffey@pa.net -No refunds during week prior to the event-