THE OFFICIAL UIC FLAMES ATHLETIC WEBSITE

2014 Howard Moore Basketball Camps

Form must be filled out completely to be eligible for entry.

Camper's Name

Camper's Email

Camper's Address

City

State

ZIP

Home Phone

Parent/Guardian Name

Parent/Guardian E-Mail

Parent/Guardian Work Phone

Parent/Guardian Cell Phone

School

Grade in Fall 2013

Age as of June 2013

Height

Weight

T-Shirt Size

Camp Dates 2014:

Form of payment:

Verify characters:

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