• Deltona Krocz  Basketball Camp

    June 8th thru Aug. 3rd 2026

    Boys & Girls: 8-16 yo.

     Register $20

    Camp fees: $50/weekly/pp

    Cash App: $CoachR58

     

     

  • Camper Information

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Important Notes

    Thiis is a basketball camp. Parents are to ptovide lunch/refreshments for their kids/campers.  I, coach Raphael aka Deltona Krocz Camp Basketball is not to be held responsible for any injuries to your child and to include death. 

    Please pick up at or by 2:00 pm.  Camp starts on June 8th thru Aug. 3rd. 2026.

    ·      The league organizers reserve the right to form the teams to ensure the talents of all teams are balanced.

    • ·  Sign Up fee is $20 per camper payable thru cash app or zelle. 

         Camp fee is $50 weekly and payable before start of camp.

    .  Fees are non-refundable...for any reasons. All payments should be sent thru Cash    App: $CoachR58.  or ZELLE.

        I give Ann Raphael, permission to use any pics/videos as seem fit to include posting on social media...

  • Emergency Contact & Health Insurance Information

  • Format: (000) 000-0000.
  • Does you have any allergies, chronic illness, or medical conditions that would limit high level activtiy?*
  • Parental Permission For Emergency Treatment

    In the event of illness or accident, I give my permission for emergency treatment by Coach Raphael or her staffl for my child, and I authorize Coach Raphael or her staff to take my child to:
    I give consent for the facility to secure any and all necessary emergency medical care for my child.

  • Format: (000) 000-0000.
  • Release of Liability

    Although the safety of all sport activities is the primary concern, indoor/outdoor sport activities at Coach Raphael, aka Deltona Krocz Basketball facilities may cause injuries and/or death to my child.  I expressly assume the risk of injury, death, and/or illness arising from any cause, and agree to waive my right to pursue any lawsuit, claim against Coach Raphael, aka Deltona Krocz Basketball. 

  • I have read and agree to the above conditions*
  • Should be Empty: