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AT A SHOOTING CAMP WITH COACH PETERSON, YOU WILL EXPERIENCE: 1. Individual Shooting Instruction 2. A
checklist to return to when your shooting is off 3. How to develop accuracy and consistency 4. Drills and challenging games to play at home
NAME:__________________________________________________________________________________________________________ Address: _________________________________________________________ Phone
#: _________________________________________________________ Emergency phone #:________________________________________________ Email address:
____________________________________________________ Age: ___________ Gender: __________
Date: ________________________ Parent/Guardian Signature: ___________________________________________
www.ChampionshipBasketballAcademy.com 505-379-8854
I hereby authorize the staff of Championship Basketball Academy to act
for me to their best judgement in any emergency requiring medical attention for the participant(s) listed here.
I also release Championship Basketball Academy and its staff from any liability for any injury or illness incurred
while at the Academy. I have no knowledge of any physical impairment that would affect my child’s/children’s
participation in the Academy. By below, I certify that I have read the above statements.
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