DAY CLINIC REGISTRATION | Ball With Purpose

NEXT DAY CLINICS:
5/20/2025 & 5/26/2025

Participated in a Ball With Purpose Camp before?

Yes

Not Yet

Upcoming Ball With Purpose Day Camps (select all that apply) Required

May 20th, 2025 ($100)

May 26th, 2025 ($100)

Parent First Name

Parent Last Name

Child's First Name

Child's Last Name

Parent Email

Parent's Phone

Child's Email

Child's Phone

Child's Birthdate

Child's School & Grade

Emergency Contact, Phone Number and Relationship to Child

Medical Concerns, Allergies, or Dietary Restrictions?

Tell us about your child

How will the camper get home? Walk? Picked up by who?

I agree to the terms & conditions of our photo/liability release formView terms of use

I understand that a submitted registration form DOES NOT secure a camp spot. We will reach out with next steps once your form is reviewed. Thank you. If clinic is cancelled or full, you will be refunded.

Clinic Fee ($100) Required

Venmo: @bornwpurpose

Cash App: $bornwithpurpose

Paypal: https://www.paypal.com/donate/?hosted_button_id=4HUJF4PSWSAB4

Thanks for submitting!

NEXT DAY CLINICS: 5/20/2025 & 5/26/2025

NEXT DAY CLINICS:
5/20/2025 & 5/26/2025