Register for the Camp

The registration fee is $150
*Receive a $25 discount if you pay before June 5th, 2010

Registration involves two steps. First, please complete the registration form below, and provide all requested information. Please complete one form for each camp participant. This will allow us to begin the registration process.

A spot will not be reserved until payment has been received. This fee covers the cost of camp participation in session specified. All participants will also receive a Kimrossi Taylor's Basketball Camp t-shirt and an award in recognition of their participation. Please make your check(s) payable to "Kimrossi Taylor's Basketball Camp" and mail to:

Kimrossi Taylor's Basketball Camp
P.O. Box 656
Bolingbrook, IL 60490-1098

If you have any questions please feel free to email us at email@kimrossibasketballcamp.com or call (630) 771-1915.

Participant's Name *
School
Grade
Date of Birth
Gender * Male Female
Shirt Size
Height (Ex: 5'4")
Parent's Name *
Daytime Phone * – – Ext.
E-Mail Address *
Address 1 *
Address 2
City *
State *
Zip Code *
Emergency Contact
Emergency Phone * – – Ext.
Please provide additional comments below.