First Name
Last Name
Nickname
Player Position	Select Player Position Point Guard Shooting Guard Combo Guard Guard/Forward Forward Center Don't Know
Date of Birth	Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985
Street Address
City
State	Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip Code
High School Graduation Year	2009 2010 2011 2012 2013 2014 2015
Height	Select Player Height 4' 5" 4' 6" 4' 7" 4' 8" 4' 9" 4'10" 4' 11" 5' 0" 5' 1" 5' 2" 5' 3" 5' 4" 5' 5" 5' 5" 5' 7" 5' 8" 5' 9" 5' 10" 5' 11" 6' 0" 6' 1" 6' 2" 6' 3" 6' 4" 6' 5" 6' 6"
Jersey	Select Jersey Size Adult Medium Adult Large Adult XLarge Adult XXLarge
Years Experience	Select Experience 0 Years 1 Years 2 Years 3 Years 4 Years 5 Years 6 Years 7 Years 8 Years 9 Years 10 Years 11 Years 12 Years 13 Years 14 Years 15 Years
AAU Team
Academic Grades/GPA
Future College Choices
List Player Strengths
Favorite Basketball Player

area code - phone
E-mail
	I understand that as a participant in the New York Regional Adidas Phenom Camp that my child is responsible for his conduct, proper use of the equipment  and facilities. I agree that the sponsors of this event will not be held liable or financially for any loss of personal property, bodily injuries, or the result thereof incurred and suffered by the applicant and members of their family. I understand and waive all financial claims that all images, whether photo, digital and/or video captured during the camp, are the property of New York Regional Adidas Phenom Camp and may be used for promotional use. I have read and accept the above disclaimer *All fields must be completed before consideration
Comments
Upload Pictures	IMPORTANT!!! Please send clear digital images of individual player head shots to jrpics@nyphenom.com Include name, state and high school graduation year.