Laramie County Community College
Golden Eagles
HOLIDAY
BASKETBALL CAMP
REGISTRATION FORM
CAMPER NAME: _____________________________________________ DOB: _________________
PLEASE PRINT
ADDRESS: _________________________________________________________________________
CITY: ______________________ STATE: ________________________ZIP: ____________________
HOME PHONE: _________________________WORK/CELL PHONE: ___________________________
PARENT/GUARDIAN NAME: ___________________________________________________________
PLEASE PRINT
PAYMENT $75: CASH CHECK EMAIL _____________________________________
PLEASE MAKE YOUR CHECK PAYABLE TO: LCCC BASKETBALL
CREDIT CARDS ACCEPTED AT THE DOOR
Laramie County Community College is committed to providing a safe and nondiscriminatory educational and employment environment. The college does not discriminate on the basis of race, color,
national origin, sex, disability, religion, age, veteran status, political afliation, sexual orientation or other status protected by law. Sexual harassment, including sexual violence, is a form of sex
discrimination prohibited by Title IX of the Education Amendments of 1972. The college does not discriminate on the basis of sex in its educational, extracurricular, athletic or other programs or in the
context of employment.
The College has a designated person to monitor compliance and to answer any questions regarding the college’s non-discrimination policies. Please contact: Title IX and ADA Coordinator, Room 117,
Student Services Building, 1400 E College Drive, Cheyenne, WY 82007, 307.778.1217, TitleIX_ADA@lccc.wy.edu.
