Bayfield High School Girls Basketball Team

Basketball Clinic for Individuals w/Disabilities

Saturday, February 7, 2015, at the BHS gym

Clinic Schedule: 12:45 registration, 1-3p skills, 3-4p free meal, 4p

watch Girls JV basketball game vs. Alamosa, and 5:30p watch Girls
Varsity game.
Clinic Staff: BHS Asst. Coach, Cathy Simbeck (a 30 year veteran
coach for Durango Special Olympics and SOCO Hall of Famer) will
be conducting the clinic with the assistance of the other coaches
and members of the Girls Basketball team.
Participants will receive a free tshirt, a free meal, and free
admission into the games. Supervision will be provided at the
games by members of the teams.
Please send participants with court shoes, appropriate clothing for
active participation, and a water bottle. For more information
please contact Cathy Simbeck at simbeck_c@fortlewis.edu or 2477586.
2015 Basketball Clinic for Individuals w/Disabilities Registration
Name: _____________________________________________ Age: __________T-shirt size _______
Address: ______________________________________City: ________________________________ Zip: ________
Phone: (____) ______________________Emergency Phone: (____) ________________________
Parent Email: ______________________________________Insurance Carrier: _____________________________
Policy Number: _____________________________________
Existing Medical Conditions/Allergies
etc.:__________________________________________________________________________
____________________________________________________________________________________________________________
I have given my child permission to participate in the Bayfield Basketball Clinic for Individuals w/Disabilities

and I certify that they are in good health and can take part in all normal clinic activities. If an injury occurs,
I authorize the clinic staff to take all proper action and use the emergency service available at the nearest
hospital if necessary. I understand my personal insurance will be used in this case. The proper calls will be
made to you before any medical attention is given. In case of extreme emergency, I authorize the
emergency personnel to take proper action.
Parent/Guardian Signature: ___________________________________________________