2018 Base Camp Application
Please fill out the information below. Once your application has been reviewed and accepted we will email you information to complete your registration including payment ($100.00 Camp Fee). If you have any questions, please direct them to lafayettehardcourt@gmail.com.

Camp will be held Saturday June 9, 2018 & Sunday June 10, 2018 at Shamrock Park (Lafayette, IN). Your registration fee includes optional pick up Friday, Saturday Workshops, and Sunday Coached Team Tournaments. A light breakfast and lunch will be provided Saturday & Sunday. If you are needing housing, please email us your housing needs (number of people and for what nights) at lafayettehardcourt@gmail.com.

CAMPER INFORMATION
First & Last Name *
Your answer
Email Address: *
Your answer
Phone Number: *
Your answer
Dietary Restrictions: *
Any Allergies?
Your answer
Emergency Contact (Name/Phone Number/Relationship to You) *
Your answer
BIKE/POLO BACKGROUND
How long have you been playing bike polo? *
Your answer
How often per week do you get to play?
Your answer
How big is your club back home?
Your answer
BIKE EQUIPMENT
What type of bike equipment do you play on?
Your answer
What type of braking do you use?
Do you use clipless pedals or any other Pedal Retention?
Are you right handed or left handed?
What do you personally hope to learn at camp?
Your answer
Anything else we should know???
Your answer
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