Registration Form

Entries will be accepted on a first-come, first-served basis. Your entry is not accepted until payment is received.

In the event you cannot attend and notice is given prior to April 1st, $100 is refundable.

First Name

Last Name

E-mail address

Address

City

Province / State

Postal Code

Phone number

Years of Experience

Current Levels Worked (Check all that apply)

CIS

ACAC

Men's Shirt Size

Payment Options

eTransfer to nextlevelcamp@shaw.ca

Cheque - payable to Karen Lasuik - mail to 9148-142 Street NW, Edmonton, AB T5R 0M7

EBOA Membership Deduction - contact Leo Mangano at treasurer.eboa@gmail.com

I agree to hold Next Level Officials Camp personnel and any other party affiliated with the camp from liability arising out of my participation in any camp activities. I afirm that I am of sound physical condition appropriate to the demands of basketball officiating.

Date

Submit