2021 Chambersburg Basketball Camp Registration Form
                                                  Fill out and send, along with payment, to: 
                                Shawn Shreffler, 1683 Sherry Drive, Chambersburg, PA 17202
                        Make checks payable to: Chambersburg Boys’ Basketball Boosters.
                Camper’s Name:                                                                                           Circle One:        Boy     Girl
                Address:                                                                                                                                                         
                                               (Street)                               (City)                        (State)                       (Zip)
                Email Address:                                                                                                                                              
                School:                                                           Grade:                        Phone #:                                             
                                               (Fall 2021)                                 (Fall 2021)
                Camp T-Shirt Size (circle one):                       YM      YL      AS      AM     AL      AXL       AXXL
                Parent/Caregiver’s Name(s):                                                                                                                      
                In Case of Emergency, Contact:                                                                                                                 
                                                                                           (Name)                                     (Phone Number)
                                                                                                                                                                                                                    
                I wish to register my child for the following camp session (check one):
                                         Session #1 – Boys Only Entering Grades 1 through 5 (Week of June 7th).
                                     Cost of camp is $85.
                                     Camp will run Monday – Thursday from 8:00 AM – 11:00 AM.
                                         Session #2 – Boys Only Entering Grades 6 through 9 (Week of June 7th).
                                     Cost of camp is $85.
                                     Camp will run Monday – Thursday from 12:00-3:00 PM.
                               There is no deadline to register.  Walk-up registrations are accepted.
                ALL SESSIONS WILL BE HELD IN THE CASHS FIELD HOUSE AND
                                                                   AUXILIARY GYM!
                The cost of registration includes quality instruction and a camp T-shirt.  All campers should 
                wear a shirt, pair of shorts, socks, and sneakers (no jewelry or hats please). 
                                                                                                                                                                                        
                I certify that my son or daughter is in good physical condition & able to participate at this camp.
                                                                                                                                                                 
                Parent’s Signature                                                                                            Date
                 Questions? Contact Coach Shreffler at 717-372-3682 or shawn.shreffler@casdonline.org.
                    “The Chambersburg Area School District does not sponsor or sanction this program/event/activity.”