* Required

Columbia Grammar & Preparatory School

Summer Basketball Camp

grades 5-8

grades 2-4

grades pk-1

Camper's Full Namerequired

Genderrequired

Current Graderequired

Which week(s) will your child be attending?required

T-shirt Sizerequired

Parent Contact #1

Full Namerequired

Email Addressrequired

Phone #required

Parent Contact #2

Full Namerequired

Email Addressrequired

Phone #required

Medical Concerns

Does your child have any medical conditions that we should know about? (Asthma, diabetes, allergies, etc.)*

Yes No

Please explain.required

Does your child take any medication that we should be aware of? (Inhaler, other.)*

Yes No

Please explain. required

Is there any other information about your child that you would like the camp staff to be aware of? *

Yes No

Please explain.required

*** I give permission for my child to participate in the 2023 Columbia Grammar and Preparatory School Summer Basketball Camp ***

Signaturerequired

Daterequired (mm/dd/yyyy)

Please send a confirmation email to the address below*: