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In consideration of acceptance for registration, I waive and release any and all rights and claims for damages my son may have against Northwest High School or its representatives for any damages that may be sustained and suffered by my son in connection with his association in this academy, and which may arise out of his traveling to, participating in, or returning from academy.

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Parent’s Signature Date

Waiver & Release Agreement

2015 Boy’s Basketball

Summer Youth Academy

Grades 3-8

Grand Island Northwest

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rand Island, NE

68803-1199

2014 District Champions

Central 10 Conference Champs 2011 & 2012

2015 Boys Youth Basketball Academy The Academy’s objective is to develop your son’s fundamental skills along with teaching the concepts of the game. We feel by meeting with your son throughout the summer we can progress through your son’s development. We will also expose your son to the following important personal characteristics : humility, passion, unity, servanthood, thankfulness and accountability. Youth Academy Schedule June 8 Grades 3-8 4:00 pm to 5:30 pm June 15 Grades 3-8 4:00 pm to 5:30 pm June 22 Grades 3-8 4:00 pm to 5:30 pm July 13 Grades 3-8 4:00 pm to 5:30 pm July 20 Grades 3-8 4:00 pm to 5:30 pm July 27 Grades 3-8 4:00 pm to 5:30 pm Academy Staff The Northwest High School Coaching Staff Coach Ryan Rathke, Coach Garrett Rathke, Coach Jake Ritzdorf and Coach John Ring along with high school players will help with the development of your son.

Coach Ryan Rathke 3836 Meadowlark Circle Grand Island, NE 68803 308-380-2351

rrathke@ginorthwest.org

Registration Form Full Name

Street Address

City State Zip

Cell Phone

Parent’s Names

Parents Phone

Grade in School 2015-2016 (circle grade) 3 4 5 6 7 8 Academy Cost $30 T-Shirt (Optional) Cost $15 Basketball (Optional) Cost $15 T-Shirt Size (circle size) Youth YM YL Adult S M L XL Write checks to Northwest Basketball Return completed registration form with the signed waiver & release agreement along with payment of academy to Northwest’s Athletic Director’s office or mail to address below.

Return by May 11th

WEBSITE Visit us at www.ginorthwest.org> Northwest High> Sports> Boy’s Basketball