2023 GSOA Camp Application

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Camp Attending: (Must Be Available From Start to Finish)* This field is required.
Choose one
Dallas, Carrollton/Lewisville, TX - May 26, 27, 28 (Fri-Sun)
Duncanville, Texas - July 7, 8, 9 (Fri-Sun)
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First Name* This field is required.
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Last Name* This field is required.
4
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
United States
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United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
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Armenia
Aruba
Australia
Austria
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The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
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Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
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Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
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Costa Rica
Cote d'Ivoire
Croatia
Cuba
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Cyprus
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Democratic Republic of the Congo
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Djibouti
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Equatorial Guinea
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Ethiopia
Falkland Islands
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France
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Malaysia
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Mali
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Martinique
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Mauritius
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Mexico
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Moldova
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Montserrat
Morocco
Mozambique
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Nagorno-Karabakh
Namibia
Nauru
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Nicaragua
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Nigeria
Niue
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Turkish Republic of Northern Cyprus
Northern Mariana
Norway
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Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
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Poland
Portugal
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Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
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Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
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Senegal
Serbia
Seychelles
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Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
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Sudan
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eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
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British Virgin Islands
Isle of Man
US Virgin Islands
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Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Cell Number* This field is required.
Area Code
Phone Number
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E-mail* This field is required.
7
Highest Level of Officiating* This field is required.
Choose one:
Choose one:
Jr. High
High School
JUCO
College (NAIA, DIII, DII, DI)
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Did You Work Games Using Three-Person Mechanics?* This field is required.
YESNO
9
Years of Officiating* This field is required.Enter here:
10
GSOA Basketball Camp Application* This field is required.
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ORDER SUMMARY
Total costUSD
GSOA 2023 Basketball Camp Application
$260.00+Edit
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Total cost $0.00
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11
Informed Consent and Acknowledgement* This field is required.Your Non-Refundable, Transferrable Camp Fee of $260 is due with your application. You will receive a confirmation email upon receipt and then be sent camp information through email approximately two weeks prior to the camp you are registered for. If you have any questions, contact Ann Stigliano at stigann@aol.com or 254-755-8170. I hereby release the staff of the Great Southwest Officials Camps and Tony Stigliano from any and all liability for accidents, injury or illness related to my participation in the camp(s). Further, I have no knowledge of any physical impairment that would affect my safe participation in the camp.
I consent
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13
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
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