The Big 60 March 24,  2018-Top 100 Elite College Exposure Application-The Big 60

         March 24 at Lancaster Bible College
901 Eden Road, Lancaster, PA 17601

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

this is for individual players, not teams-
All 3 games live streamed & placed on YOUtube

-Check the schedule two days before the event to see what time you play, go to www.pahoops.org
 

First Name ____________________________Last Name ________________________________ Gender  _______

Address _______________________________________

City _______________________________              State ________        Zip code   ___________

Print email address  _______________________   Home phone ____________________    Birth date ____________

Height _______  Weight ______                                 Graduation year (circle one)     ___2019   ____2020 ____2021    ____2022 ____2023

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 March 24- $128.00  Boys Shootout,  early registration up to March 9- at Lancaster Bible College- late registration March 10  to day of the event $140.00.
___________   For March 24 - $128.00   Girls Shootout,    early registration up to March 9- at Lancaster Bible College- late registration March 10  to day of the event $140.00.
 

  Send your check or money order (payable to: Bill Gaffey)  with your application and mail your completed application to 
Bill Gaffey    417 Bolton Drive, Harrisburg, PA   17112

 -To pay by credit card on our Pay Pal Account 
1-Type in the name of the player in the "Player's Name" box
2-Click on the 
Buy Now Button  
3-If you do not have a Pay Pal account, then scroll down to "Pay with Debit or Credit Card" and complete your payment.
4-If you have a Pay Pal account then use it to complete your payment.

Player's Name

For more information or help-call 717-545-0872 -email wgaffey@pa.net -