Private Basketball Training Registration
Enter the athlete and parent/guardian details, preferred training times, and complete the waiver agreement.
Athlete Information
First Name
*
Last Name
*
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Training Dates & Times
Enter up to three preferred training date/time options. You may write entries like “Sundays Dec 1 - 11am to 12.”
Option 1
Option 2
Option 3
Training Preferences
Preferred Training Duration
*
Please Select
30 minutes
45 minutes
60 minutes
90 minutes
Basketball Position
*
Please Select
Point Guard
Shooting Guard
Small Forward
Power Forward
Center
Other
Skill Level
*
Beginner
Intermediate
Advanced
Elite
Basketball Goals
Waiver and Release of Liability / Participant Agreement
Waiver and Release of Liability
Participant Agreement and Waiver Acknowledgment
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Adult Participant or Parent/Guardian Signature
*
For Office Use Only
Training Date Confirmed
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Coach Assigned
Session Duration
Hour Minutes
AM
PM
AM/PM Option
Submit
Submit
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