DRIVE Basketball Academy Spring Registration Form

DBA

Spring Training

Registration Form

1214 Turrentine St, Burlington, NC

Athlete Information

Player Name*

First NameLast Name

Grade*

Guardian / Parents Names*

First NameLast Name

Address*

Street Address

Street Address Line 2

City

Postal / Zip Code

E-mail*

Cell Phone

Area CodePhone Number

Athletic skill level*

	1	2	3	4	5

1 is Beginner, 5 is Advanced

Important Notes

· Dress appropriately.

· Keep the gym clean.

. Bring your own athletic drink, bottled water will also be available.

Training Groups & Times: Tuesday and Thursdays

. 3rd–5th Grade: 3:40 PM – 4:30 PM
. 6th–8th Grade Boys: 6:00 PM – 6:50 PM (Tuesday Evenings)
. 6th–9th Grade Girls: 7:00 PM – 7:50 PM (Tuesday Evenings)

*No workouts the week of Spring Break.

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Area CodePhone Number

Do you have any allergies, chronic illness, or medical conditions that would limit high level activity?*

YesNo

Please describe

My Products*

12 Week Speed, Agility, and Quickness Training (Begins Tuesday March 3rd ends May 26th) $360.00

Registration Fee: $360.00 Includes 12 skill training sessions, once a week on Tuesday.

12 Week Basketball Skills Training (Begins Thursday March 5th ends Thursday May 28th)$360.00

Registration Fee: $360 Includes 12 skill training sessions, once a week on Thursday.

12 Week Skills and Speed and Agility Training (Begins Tuesday March 3rd ends Thursday May 28th)$480.00

Registration Fee: $480 Includes 12 skill training sessions and 12 speed and agility training sessions, on Tuesday and Thursdays.

Enter coupon

Total $0.00

Release of Liability

Although the safety of all during basketball activities is the primary concern, basketball activities at DRIVE Basketball Academy facilities may cause injuries and/or death. I assume the risk of injury, death, and/or illness arising from any cause, and agree to waive the right to pursue any claim against the DRIVE Basketball Academy and the persons in charge.

Make Up Days

There are no make up days built into the Spring group training program.

I have read and agree to the above conditions*

YesNo

Parent's Signature/ Child's Signature*