By signing my name below, I attest that I am in proper health to participate in the D3 Super Camp and do hereby release D3 Super Camp and staff: Director-Gregg Bennett, Co-Director-Dennis Ashcraft and the North Carolina State University from any fault, obligation, or penalty resulting from any medical injury, infirmity, or disability as a result of my participation in this basketball camp.
Please Download the Above Physical Exam Form and Return Prior to Camp to:
Gregg Bennett / D-III Super Camp
1620 Centerville Parke Lane
Manakin Sabot, VA 23103