Register for Camp - Burlington County All-Star Basketball Camp

On this page, you can register on-line for the camp. On-line registration only involves the application. The Medical Form must be printed out and sent in by mail, along with your deposit. Complete the first part of the registration process so your information will be on file and then send in your Medical Form and payment.

* Denotes Required Fields. Failure to complete some of these fields may result in rejection of registration.

Name*:
Address*:
City*: State*: Zip Code*:
Home Telephone*:
Parent Daytime Telephone*:
Grade Entering in September 2010*:
Age At Camp*: Height(i.e. 5'0")*: Weight(lbs.)*:
School Name*:
Coach's Name*:
Gender*: Male Female
Birthdate*: Year:
Parent Name*:
Parent E-mail*:
How did you hear about our camp?:

Packages
Please Choose (You may choose more than one)*:
1. July 19 - July 23, 2010 at Holy Cross High School....$175.00
2. July 26 - July 30, 2010 at Holy Cross High School....$175.00
3. Insurance - per week....$10.00

After submitting this form, please print and send in the completed Medical Form along with a non-refundable deposit of:
$100.00 deposit for 1 week
$140.00 deposit for 2 weeks

Enroll 2 weeks.......Take $25.00 off total
Make check or money order payable to:
Jay Flanagan Basketball, LLC
11 Liberty Trail
Delran, NJ 08075

IMPORTANT: Balance is due on or before July 1st, 2010

For further information call:
856.824.0810
856.393.8068 (Fax)
bballcamp@coachflanhoops.net (email)