2024-25 Dawson Basketball Camp

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Brochure

Application Form

June 16-19, 2025

Campers First Name *

Campers Last Name *

Email address *

Address 1 *

City *

State *

ZIP Code *

Cell Phone Number *

Parents Name *

Emergency Contact *

Emergency Contact Phone Number *

School? *

Grade going into? *

Age of camper in June? *

T Shirt Size? *

YXS YS YM YL AS AM AL AXL AXXL

Camp Session? *

Age: 4-6 (11:30-12:30) $75 Age: 7-10 (8:30-11:00) $100 Age: 11-16 (1:00-3:30) $100

Insurance Plan *

Policy Holder's Name? Policy/Group NO.

Is Camper allergic to any medication? *

Any Medication being sent with camper? *

Print Name: *

By printing your name here, you are agreeing to this statement, "I approve of my child's attendance at the DCC camp and certify that she/he is in good health and able to participate in the camp. I authorize all camp affiliate personnel to act for me according to their best judgement in any emergency requiring medical attention. I understand, should any emergencies arise, I will be contacted immediately. I hereby release and waive DCC camp, the director, counselors and Dawson Community College from any and all liability.

4-6 years old $75
6-10 years old $100
11-16 years old $100

Contact Information:

Joseph Peterson
jpeterson@dawson.edu

* required field