PUSH Basketball Camp Registration
July 28th - August 1st, 2025
9:00 am - 2:00 pm (Drop off begins at 8:45 am)
$200 per camper

Campers will need to bring their own lunch. Concessions will be available for drinks and snacks. 


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Parent Name *
Parent E-Mail Address *
Parent Phone Number *
Parent Home Address *
Camper First Name *
Camper Last Name *
Camper's Age *
Camper's Shirt Size *
Health Insurance Company *
Health Insurance Policy Number *
Emergency Contact First & Last Name *
Emergency Contact Phone Number *
Waiver

By registering my child for the PUSH Basketball Academy Basketball Camp, I hereby grant approval for my child to take part in the PUSH Basketball Academy Basketball Camp at Dr. Phillips High School. I confirm that my child is in good health and capable of participating in all camp activities without any limitations. In the event of a medical emergency and if I am not present or cannot be reached, I authorize the procurement of necessary medical attention. Furthermore, I release Ben Witherspoon, Daryl Dorsey, PUSH Basketball Academy, Dr. Phillips High School, Orange County Public Schools, and all camp volunteers from any liabilities related to injury or illness.
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Required
Digital Signature
(Parent's First and Last Name)
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Date
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