2019 Don Dziagwa Basketball Camp Registration
This form is a pre-registration. A $50 deposit to secure a spot, or the full payment, is to be mailed to the following address:
c/o Tampa Catholic High School
4630 N. Rome Ave.
Tampa, FL 33603
Please note: Make all checks payable to DON DZIAGWA.
Please check week(s):
Grade in the fall
Kinder or 1st
First, Last (if different)
Street, City, State, Zip
Parent Phone/Emergency Contact
(area code) ___ - ____
I hereby authorize the Directors of the Don Dziagwa Basketball Camp to act for me according to their best judgment in an emergency requiring medical attention. I hereby waive and release the Don Dziagwa Basketball Camp and Tampa Catholic High School. I know of no mental or physical problems that may affect my child's ability to safely participate in this camp. I will be responsible for any medical or other charges in connection with his/her attendance at camp.
I will be paying by:
NOTE: Make checks payable to DON DZIAGWA.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service