Georgia Southern Basketball PO Box 8082 Statesboro, GA 30458 912-478-5327(o) 912-478-0095 (f) www.gseagles.com 2014 Mark Byington Elite Skills Camp Application Elite Camp-June 28 Rising 8 th through 12 th Graders Cost: $50 per participant (includes Lunch &Camp Shirt) $25 Deposit to Hold Spot Registration: 10am to 11am, Camp goes from 11am -5pm Medical Requirements: Physical within past year, copy of front and back of insurance card Camp Highlights Skill Development from Georgia Southern Staff and Players Perimeter skills: Handling pressure, shooting, ball handling, reading screens, winning the channel, Ball Screens Post Skills: Foot work, Racing to the X, Post Development Circuit, Post Moves, Shooting, Setting Screens Elite On-Campus Facility Free Throw Clinic Recruiting Discussion Compliance Discussion Camper of Day receives official Georgia Southern Apparel Registration Student- Athlete: Home Address: High School: AAU Team:_ Cell Phone: Email: Twitter: Coach: Coach Email: Guardian: Guardian Phone: Guardian Email: Age Grade Contact Information Camp Directors: Pierre Jordan 912-478-5327(o) 912-478-2352 (f) Email: pjordan@georgiasouthern.edu Twitter: Ga_SouthCoachB Website:www.gseagles.com The 2014 Mark Byington/Georgia Southern Team Camp is open to any and all teams, limited only by number, age, grade level, and/or gender
Georgia Southern/Mark Byington Elite Basketball Camp Registration Form Please complete the registration form, health information form, along with your check for $50, payable to Byington Basketball L.L.C. We have included local hotel information if you would like to stay in the great city of Statesboro. Mail your completed forms and your check to: Men s Basketball Office GSU Camps Georgia Southern University Post Office Box 8082-02 Statesboro, GA 30460 Name Parent/Guardian Address City ST Zip Parent Home Phone Parent Work Phone Grade Next Yr. Age Height Weight High School Name High School Coach H.S. Coach Phone AAU Coach AAU Coach Phone Summer Plans T-shirt Size
Registration will NOT be complete until we are in receipt of this signed form. Since most of the students are under the age of 18 when attending our school, it is necessary that our doctors have the permission to administer first aid and treat any problems that may arise in the unlikely event of a medical emergency. If the camper is 18 years of age, he must sign his own name on this form. Camp Date Camper Name Social Security Number PARENTAL CONSENT AND WAIVER OF RESPONSIBILITY In consideration of Mark Byington Camp acceptance of as a student in Sports camp for the period in the dates mentioned above. It is agreed that all risks attendant to watching and/or participating in camp activities including, but not limited to bodily injury, are assumed by the student and his parents and/or legal guardian and that this assumption is acknowledged, approved, and agreed to by said student and his parents and/or legal guardians as indicated by their signature hereto. I hereby grant permission for physicians, dentists, other licensed health care providers and their designees to administer outpatient medical, surgical, or dental services as appropriate, or necessary antigens or other injections, to perform emergency procedures as necessary or to refer to duly licensed medical personnel when indicated. Parent or Legal Guardian Signature Date MEDICAL CLEARANCE I hereby certify the named camper is physically able to participate in Mark Byington Basketball Camps and that I know of no physical impairments which would in any manner limit his/her participation in such program. Physician s signature must be accompanied by Physician s physical/screening or a copy of a state high school physical must be presented at camp check-in Physician s Signature Date MEDICAL INFORMATION Hospitalization Plan: Claim No. Company City State Zip Code Phone *FRONT AND BACK COPY OF INSURANCE CARD SHOULD BE INCLUDED AT TIME OF CHECK-IN* Medical History (if pertinent): Allergies, present medication, special considerations: Parent/Guardian Address City State Zip Code EMERGENCY MEDICAL INFORMATION ( ) ( ) NAME PHONE CELL
MARK BYINGTON ELITE CAMP @ GEORGIA SOUTHERN UNIVERSITY POSSIBLE HOTELS: *HOTEL COST IS NOT INCLUDED IN CAMP FEES. FEEL FREE TO CALL OR EMAIL Us WITH ANY QUESTIONS. (912) 478-5327 gshoopscamp@georgiasouthern.edu COMFORT INN & SUITES Laundry Outdoor pool Pets allowed ADDRESS: 17870 Georgia 67, Statesboro, GA 30458 PHONE #: (912) 681-2400 BAYMONT INN & SUITES Laundry Outdoor pool Pets allowed ADDRESS: 425 S Main St, Statesboro, GA 30458 PHONE #: (912) 489-7368 SPRING HILL SUITES STATESBORO UNIVERSITY AREA Laundry Outdoor pool ADDRESS: 105 Springhill Drive, Statesboro, GA 30458 PHONE #: (912) 489-0000 HAMPTON INN (New) Hampton Inn Statesboro, GA hotel is located in the heart of the city. All rooms include free internet and hot breakfast ADDRESS: 350 Brampton Ave, Statesboro, GA 30458 PHONE #: (912) 489-8989 HOLIDAY INN STATESBORO UNIVERSITY AREA Accessible facilities Bar Business center Free WiFi Free parking Gym Laundry Outdoor pool Restaurant Room service ADDRESS: 455 Commerce Dr, Statesboro, GA 30458 PHONE #: (912) 489-4545 LA QUINTA INN STATESBORO Indoor pool Pets allowed ADDRESS: 225 Lanier Dr, Statesboro, GA 30458 PHONE #: (912) 871-2525
2014 Georgia Southern Elite Basketball Camp Statesboro, GA Hanner Field House Address: 590 Herty Dr. Statesboro, Georgia (912) 478-1425 Confirmation This is a confirmation that your registration material has been received for the 2014 Georgia Southern University Elite Camp held on Saturday, June 28 th. Registration for all camper will be from 10:00am to 11:00am at the Main Entrance of Hanner Fieldhouse located at 590 Herty Dr. If you are showing up early, the building may be closed. If you are showing up a later time, please let us know. On the following page is a map and directions to get to Hanner Fieldhouse. The camp will conclude at 5pm. Please call me with any questions. We look forward to seeing you soon.
Hanner Fieldhouse Address: 590 Herty Dr. Statesboro, Georgia Traveling from the Atlanta/Macon Area: (From I-75 South/I-16 East/Highway 301 North) 1. Travel East on I-16 to exit 116 (Statesboro/Claxton and Georgia Southern University exit). 2. Turn left onto Highway 301 at the top of the exit ramp. 3. Drive approximately 9 miles. At the third traffic light, turn right onto Veterans Memorial Parkway/ Bypass. (As a point of reference look for the Texaco Station on your left at the intersection). 4. After turning, you will pass through two lights (1st Akins Boulevard, 2nd Lanier Drive ). 5. At the third light, turn left onto HWY 67/Fair Road. 6. After turning, you will travel through three lights (1st Bermuda Run Road, 2nd Gentilly Road, 3rd Chandler Road) 7. At the 4th traffic light, turn left onto Herty Drive. 8. Hanner Fieldhouse will be on your right Traveling from Savannah/Florida/South Carolina: (From I-95 North or South/I-16 West/GA 67 North) 1. Travel West on I-16 to exit 127 (Statesboro and Georgia Southern University exit). 2. Turn right onto Highway 67 North at the top of the exit ramp. Drive approximately 10 miles. 3. Upon entering the Statesboro city limits you will pass through four (4) traffic lights (1st Veterans Memorial Parkway, 2nd Bermuda Run Road, 3rd Gentilly Road, 4th Chandler Road ). 4. At the 5th traffic light take a left onto Herty Drive. 5. Hanner Fieldhouse will be on your right. Traveling from Augusta and other routes on Highway 25 and Highway 80: 1. Come into Statesboro on Hwy 25/Hwy 80 (also called Northside Drive ). 2. At the 4th traffic light, turn right onto Highway 301 South/Main Street. (The first traffic light on this route will be at the Veterans Memorial Parkway/Bypass. It will be a half a mile before the second light). 3. You will pass through three traffic lights (1st East/West Main Street, 2nd Grady Street, 3rd East/West Jones Avenue ). 4. At the 4th traffic light, turn left onto Tillman Road. (As a point of reference look for Gnat s Landing Restaurant on your left at the intersection). 5. At the next light, turn right onto Hwy 67/Fair Road. 6. At the next light, turn right onto Herty Drive. 7. Hanner Fieldhouse will be on your right
MAP of Georgia Southern University (Hanner Fieldhouse)