JOE WHALEN’S BASKETBALL

SKILLS CAMP

Sponsored by the West Long Branch Sports Association

COACH JOE WHALEN

§ Head Coach: Long Branch High School (Present); Central Jersey Group III Champions (2005)

§ Assistant Coach St. Anthony High School; consensus National Champions (2007-2008) - With Hall of Fame Coach Bob Hurley

§ 2004-2005 Shore Conference Coach of the Year

§ 2006 JSBL Coach of the Year

§ Head Coach: Cohen’s Optical; JSBL Champions (2006)

§ Head Coach: Team Izod 17 yr old (Present) - National Boys AAU Program

§ Head Coach: Central Jersey Hawks (Present) - National AAU Program

§ Head Coach: Jersey City Boys Club - National Boys AAU Program

§ Head Coach Jersey Shore Wildcats - National Girls AAU Program

COACH RYAN WHALEN

§ Assistant Coach Seton Hall University (Present)

§ Assistant Coach Iona College (2009-2010)

§ Assistant Coach Towson University (2008–2009)

§ Student Assistant Coach: Saint Joseph’s University (2005-2008)

§ Intern with the Philadelphia 76ers (2007)

§ Assistant Coach Central Jersey Hawks AAU Team (2007)

§ Member of Nationally Ranked Jersey City Boys Club AAU Basketball Team

BOYS GIRLS

August 15th – 18th August 15th – 18th

8:30 am- 12:30 pm 1 pm- 5 pm

TUITION: $175 per session GUEST SPEAKERS:

($50 deposit due with application) (Division I Coaches)

Checks payable to: West Long Branch Sports Association

FACILITY: Frank Antonides School Gymnasium

Locust Avenue, West Long Branch

ANY QUESTIONS: Joe Whalen

ENJOY QUALITY INSTRUCTION IN A SMALL SETTING!!!

SPACE IS LIMITED!!! DON’T GET SHUT OUT!!!

Please return by August 4th to ensure enrollment

JOE WHALEN’S BASKETBALL

SKILLS CAMP

Sponsored by the West Long Branch Sports Association

Name

Address

City State

Zip

Home Phone

Emergency / Cell Phone

Date of Birth

Entering Grade (September 2010)

Height Weight

T-Shirt Size (Adult Size)

E-mail

PARENTAL CONSENT FORM

The undersigned, being a parent or legal guardian of the child requesting participation in the camp, does hereby affirm that the applicant is in good health and suffers from no illness, disability or condition that requires the taking of medication on a regular basis unless that condition is disclosed and approved. Furthermore, the undersigned has no knowledge of any reason the applicant cannot participate in vigorous physical activity.

The undersigned hereby expressly agrees to be responsible for any medical bills incurred in the treatment of any illness or accident. In the event of any such injury, I hereby consent to allowing any of the camp supervisors to procure any medical treatment deemed advisable on behalf of my child or ward without prior consent. No medical insurance is provided by Joe Whalen’s Basketball Skills Camp.

I understand that as a condition of admittance to Joe Whalen’s Basketball Skills Camp sponsored by the West Long Branch Sports Association , the undersigned, on behalf of all parents and guardians of the applicant, hereby releases Joe Whalen’s Basketball Skills Camp, West long Branch Board of Education, Frank Antonides School, and all employees or agents of the camp or schools from any and all liability from injury or illness, mental or physical, suffered by the camper during or related to camp.

MEDICAL/ HEALTH INSURANCE CO.

POLICY #

Signature of Parent / Guardian Date Signed

A non-refundable deposit of $50 is to accompany the application. Balance and medical forms must be received before the start of the first session of camp.

Each participant is subject to immediate dismissal if he or she does not comply with the rules and regulations of the camp or if the student is found to be detrimental to the interest of the program.

Please return this registration form to your West Long Branch Basketball Coach by August 4th or

mail this form and your deposit by August 4th to:

West Long Branch Sports Association

Attn: Joe Whalen Basketball Camp

P.O Box 239

West Long Branch, NJ 07764