2023 Collegium Basketball Camp Registration Form
Objective:
Students entering Grades 2nd - 7th by August 2023 will learn the fundamentals of the game from CCS Basketball Coaches and student-athletes.

Location: Collegium Charter School, William D. Winters Gymnasium (535 Building) 535 James Hance Court, Exton, PA 19341
     
Camp Registration:
$175.00 per session per child  

Walk In Registration: Only available on Monday of each session.  
$200.00 per session per child for walk-in registration.

Camp Sessions:
Session #1 - Monday, June 19th- Thursday, June 22nd
Session #2 - Monday, July 31st- Thursday, Aug 3rd


Camp Hours:
Regular Hours - 9:00am - 3:00 pm
Before Care Hours (offered for an additional charge of $25 per camper per week) - 8:00am - 9:00am
After Care Hours (offered for an additional charge of $50 per camper per week) - 3:00pm - 5:00pm

Space is limited and we suggest registering as early as possible. Please complete one registration form per camper.  

Questions? Contact High School Boys Head Basketball Coach,  Mr. Markel Jones at MJones@ccs.us
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Email *
Camper First Name *
Camper Last Name *
Camper 2022-2023 Grade Level *
Remember 2022-2023 is next school year.
Camper T-Shirt Size *
Registered campers receive one (1) free camp shirt. Please indicate size below.
Collegium Basketball Camp Photo Release *
From time to time, photos of campers "in action" will be taken to be used on our website, on our social media accounts, and by outside publications. This is a great way to recognize the efforts of our campers and to inform the surrounding community about the exciting things happening at CCS Basketball camp. Please answer "YES" if you will allow us to use your child(ren)'s photos for the above purposes or answer "NO" if you do not want us to use your child(ren)'s photos for the above purposes.
Primary Parent/Guardian Name *
Secondary Parent/Guardian Name
Primary Email Address *
Primary Phone Number *
(XXX) XXX-XXXX
Indicate Primary Phone *
For the primary phone number you indicated, please select type from the list below.
Emergency Contact #1 *
Below, please indicate the first and last name of an individual (other than the primary and secondary parent/guardian) authorized to be an emergency contact. This individual will be contacted in the event of an emergency in which a parent/guardian is unavailable.
Emergency Contact #1 Relationship To Camper *
Below, please indicate the relationship between the emergency contact listed above and your camper.
Emergency Contact #1 Primary Phone *
Below, please write the primary phone number for the individual you indicated above. (XXX-XXX-XXXX)
Emergency Contact #2
Below, please indicate the first and last name of an individual (other than the primary and secondary parent/guardian) authorized to be an emergency contact. This individual will be contacted in the event of an emergency in which a parent/guardian is unavailable.
Emergency Contact #2 Relationship To Camper
Below, please indicate the relationship between the emergency contact listed above and your camper.
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Emergency Contact #2 Primary Phone
Below, please write the primary phone number for the individual you indicated above. (XXX-XXX-XXXX)
I Am Registering My Child For The Following Session(s) *
Please select the sessions in which you are registering your child. If registering for both sessions, please indicate that by checking both boxes below.
Required
My Child Will Need Before-Care For Session #1 *
Before Care is offered from 8:00am - 9:00am for an additional cost of $25 per camper for Session #1
My Child Will Need After- Care For Session #1 *
After Care is offered from 3:00pm - 5:00pm for an additional cost of $50 per camper for Session #1
My Child Will Need Before- Care For Session #2 *
Before Care is offered from 8:00am - 9:00am for an additional cost of $25 per camper for Session #2
My Child Will Need After- Care For Session #2 *
After Care is offered from 3:00pm - 5:00pm for an additional cost of $50 per camper for Session #2.
Please total your Collegium Basketball Day Camp payment and applicable before care and/or after care fees  Below, please indicate your payment method.   *
Notes
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