Built different hoops lab Girls Basketball Clinic Registration

CALLING ALL GIRLS! Inaugural Girls Basketball Clinic Girls Ages 6–13 (Grades 1–8)

⭐ ALL SKILL LEVELS WELCOME!
Only 25 spots available
Space is limited to 25 players. Registration is first come, first served. If this clinic fills, additional families may join the priority interest list for future Built Different Hoops Lab clinics and programs.
We’re excited to have your athlete join us for our Girls Basketball Clinic! Whether she’s picking up a basketball for the first time or already plays on a team, our goal is to provide a fun, positive, and encouraging environment where every girl can learn, grow, build confidence, and develop a love for the game.
🏀 Our Mission

Built Different Hoops Lab exists to inspire, empower, and develop girls through basketball. We create a positive space where players can learn, grow, and enjoy the game while being supported by encouraging coaches and a strong community. Our goal is to help every girl leave feeling motivated, included, and proud of her progress.
📅 Clinic Information

📅 Date: Saturday, September 5, 2026 🕙 Time: 11:00 AM–1:30 PM 📍 Location: Culpeper County Fieldhouse 👟 What to Bring: • Athletic clothing • Basketball shoes preferred (athletic shoes are welcome) • Water bottle (required) • Basketball (if available) ⏰ Please arrive 10–15 minutes early for check-in.
📅 Date: Saturday, September 5, 2026 🕙 Time: 11:00 AM–1:30 PM 📍 Location: Culpeper County Fieldhouse 👟 What to Bring: Athletic clothing, basketball shoes preferred, water bottle, basketball if available. Please Leave at Home • Jewelry • Gum • Valuable personal items These items should be left at home to help provide a safe, organized, and distraction-free clinic.
Player Registration 🏀
Player's Full Name

First NameLast Name
Player Age
Preferred Name/Nickname
Date of Birth

MonthDayYear
Date
Current Grade (1–8)
T-Shirt Size
Basketball Experience
How would you describe the player's basketball experience?

Other
Parent/Guardian Information
Parent/Guardian Full Name

First NameLast Name
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email
example@example.com
Parent Communication
How did you hear about this clinic?

Other
How would you like to receive important clinic updates?
Emergency Contact Information
Emergency Contact Name

First NameLast Name
Who is authorized to pick up your athlete?

Other (please specify)
Emergency Contact’s Relationship to Player
Is there anything Coach T should know to help your athlete have a successful experience? (Learning differences, anxiety, injuries, behavioral concerns, accommodations, etc.)
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Medical Information
Does the player have any food allergies?
Please explain the food allergy and any emergency instructions.
Does the player have any medication allergies?
Please explain the medication allergy and any emergency instructions.
Does the player have any environmental allergies?
Please explain the environmental allergy and any emergency instructions.
Does the player have asthma?
Please explain the asthma condition, inhaler use, and emergency instructions.
Does the player use an inhaler?
Does the player have any medical conditions?
Please explain the injury, medical condition, activity restriction, or accommodation.
Please list all current medications and anything the coaching staff should know.
Does the player have any injuries or restrictions?
Health Confirmation
I confirm that I have provided complete and accurate information about my child’s health, allergies, medications, injuries, medical conditions, activity restrictions, and emergency needs.
I confirm that the medical information provided in this registration form is complete and accurate.
Clinic Policies
Registration is required. Spots are limited. Please arrive 15–20 minutes early, wear athletic clothing and basketball shoes, and bring a water bottle (and basketball if required). If you cannot attend, notify Coach T at least 24 hours before the clinic. Families will be notified by email or text if the schedule or location changes.
Parent & Player Expectations

Show respectful behavior toward coaches, players, officials, volunteers, and families.• Demonstrate good sportsmanship at all times.• Follow coaches’ instructions promptly and respectfully.• Prioritize safety and stay aware of the activity and surroundings.• Use appropriate language and positive communication.• Respect the facility, equipment, and all clinic property.• Support positive sideline behavior and encouragement.• Coach T may remove a participant for repeated unsafe or disruptive behavior.
Parent Code of Conduct
Player Code of Conduct
I certify that my athlete is physically able to participate in basketball activities. I confirm that I have disclosed all known medical conditions, allergies, medications, injuries, activity restrictions, emergency medical information, and any other information that could affect my child’s safe participation. I understand that failure to provide accurate medical information may impact my child’s ability to safely participate in the clinic.
Registration Accuracy
Communication Acknowledgment
If Coach T launches a competitive girls basketball club, would your athlete be interested in learning more?
🏀 Join the Built Different Family
Which Built Different Hoops Lab programs would you like to learn more about? Select all that apply.
Would you like to receive occasional emails about future clinics, camps, training programs, and girls basketball opportunities?

Other
Photo Release
Parent/Guardian Verification
By typing my full legal name below, I certify that I am the parent or legal guardian of the participant, that I have read and agree to all clinic policies and the Liability Waiver & Release of Liability, and that the information provided in this registration form is true and accurate.
Parent/Guardian Full Name

First NameLast Name
Date Signed

MonthDayYear
Date
Parent / Legal Guardian Signature
Would you like to receive occasional emails about future clinics, camps, training programs, and girls basketball opportunities?

Other
I have read, understand, and agree to the Liability Waiver & Release of Liability.
My Products
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1 Player Registration
$15.00



2 player registration
$25.00



3 player registration
$35.00



Total

$0.00
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CALLING ALL GIRLS! Inaugural Girls Basketball Clinic Girls Ages 6–13 (Grades 1–8)

🏀 Our Mission

📅 Clinic Information

Player Registration 🏀

Basketball Experience

Parent/Guardian Information

Parent Communication

Emergency Contact Information

Medical Information

Health Confirmation

Clinic Policies

Parent & Player Expectations

🏀 Join the Built Different Family

Parent/Guardian Verification

My Products*

My Products