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Penny Hardaway Basketball Camp
Basketball camp my Memphis head coach and legend Penny Hardaway
info@pennyhardawaybasketballcamp.com
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About Penny
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Day Camp 1
Day Camp 2
Middle School Elite Camp
High School Elite Camp
Waiting List
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Registrant's Name
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First
Last
Email Address (All event communication will be sent to this e-mail address)
*
Email
Confirm Email
Street Address
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Address Line 1
Address Line 2
City
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Colorado
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District of Columbia
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South Carolina
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Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Grade (as of Fall 22)
*
Cell Phone
*
Home Phone
Age (at time of camp)
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Select...
8
9
10
11
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13
14
15
16
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18
School
*
Heigth
*
Shirt Size
*
Youth - S
Youth - M
Youth - L
S
M
L
XL
XXL
XXXL
Parent or Legal Guardian Name
*
First
Last
Parent or Legal Guardian Email Address
*
(All event communication will be sent to this e-mail address)
Parent or Legal Guardian 2
*
First
Last
Parent or Legal Guardian Email Address 2
*
(All event communication will be sent to this e-mail address)
Emergency Contact Name
*
Emergency Contact Phone
*
Emergency Contact Relationship
*
Name of Health Insurance Company
*
Insurance Mailing Address
*
Insurance Policy Number
*
Group Number (if applicable)
Policy Holder's Name
*
Policy Holder's Date of Birth (m/d/y)
Policy Holder's Relationship to Participant
*
Policy Holder's Employer
Does your camper have any allergies?
*
Yes
No
If so, what is your camper allergic to?
Dietary Restrictions
Does your camper have any physical or medical conditions that we should know about?
*
Yes
No
If so, what is the condition and what is the current treatment?
Is your camper currently taking any medication?
*
Yes
No
If so, what is the medication and dosage?
Relationship to Camper
*
Are you a University of Memphis Student?
Yes
No
Check
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I accept the
Penny Hardaway Basketball Camps Waiver of Liability
Waiting List
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