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Whiz Kid Training Camp Registration

If you are interested in attending the Whiz Kids Training Camp, please print out the registration form below and mail or fax it along with your payment (please make checks payable to Clutch City Foundation) to:

Houston Rockets
Attn: Whiz Kids Training Camp
2 Greenway Plaza, Suite 400
Houston, TX 77046
FAX: (713) 963-7358

Name: __________________________________________________________

Address: ________________________________________________________

City: ____________________________________________________________

State: ___________________________________

Zip: _____________________________________

Home Phone Number: ______________________

Work Phone Number: _______________________

Grade Level: ______________________________

Age: _____________________________________

I Will Attend: (circle one)
1st Session: June 17-21 (8:00 a.m. - 2:00 p.m.)
2nd Session: June 24-28 (8:00 a.m. - 2:00 p.m.)
Both Sessions

T-shirt Size: (circle one)
S M L XL

Total Amount Enclosed: $___________

Check Enclosed (Y/N):_______________

Visa #:________________________________________
Mastercard #:__________________________________
American Express #:_____________________________

Date of Expiration: _______________________________

Signature: _____________________________________

You will be required to sign a release and indemnity agreement prior to start of camp.