Contact

Phone *

Medical Plan *

Championship Basketball School

Massachusetts Maritime Academy

101 Academy Dr, Buzzards Bay, MA 02532

Mailing Address

John O'Neil

8 Great Hill Drive

Topsfield, MA 01983

Phone: +1.978-335-2696

E-mail: buddyoneil@comcast.net

checks payable to above

*school phone number will be added closer to camp weeks*

***Deposit of $100.00 MUST be sent in to the above address at the same time as application.***

Application

Championship Basketball School

Parent or Guardian Signature *

Address

Height *

City, State, Zip *

School, Grade in Sept 2020 *

Address *

Confirm *

I hereby authorize the directors to act or me in any medical emergency. In addition, our child understands that he/she must conform and obey to all rules and regulations of the Championship Basketball School.

Week Attending *

Girls Week: July 12-16

Boys Grades 4-8: July 19-23

Boys High School: July 26-30

Day Camper or Overnight *

Day Camper ONLY

Overnight

Roommate Request (2/room)

Age *

Name: *

Medical Insurance # *