CAMP/CLINIC REGISTRATION FORM | Shooters Elite Basketball

Please submit this completed registration form with payment to assure your reserved spot!

GYM LOCATION:

ST. ROBERT BELLARMINE

143 N. 5TH STREET

BURBANK, CA 91501

Camper's First and Last Name

Age and Date of Birth

T-Shirt Size

Grade and Current School

Parent / Guardian Name

CAMP IS $450 PER WEEK ~ 9:30AM - 2:00PM

WEEK 1: JUNE 15TH - JUNE 18TH (NO Camp on Juneteenth ~ 6/19)

WEEK 2: JULY 6TH - JULY 10TH

BOTH: WEEK 1: JUNE 15TH - 18TH & WEEK 2: JULY 6TH - 10TH

Lunch Options

My child will bring their own lunch and drink daily

I will pay in advance for lunch and drink, amount will be included in payment. ($15 per day - additional $60 for Week 1 and/or $75 for Week 2 )

PLEASE HAVE YOUR CHILD AT THE GYM AND READY TO START AT 9:30AM AND PICK UP PROMPTLY AT 2PM DAILY

Initials

Andy Dardaine, staff, volunteers, and/or St. Robert Bellarmine accept NO liability for any injury that may occur during our basketball camps.

I give my child permission to attend the Andy Dardaine Basketball Camp and participate in all activities.

Signature, Phone Number, and Date (This text box serves as written signature and approval)

SPACE IS LIMITED! RESERVE YOUR SPOT NOW ~ FOR MORE INFO EMAIL: andydardainebasketball@gmail.com

Payments can be made using:

VENMO: @Andy-Dardaine-Basketball

ZELLE: andydardainebasketball@gmail.com

BUILDING CONFIDENCE THROUGH ABILITY

*Payments are final ~ NO refunds