DRIVE Basketball Academy Registration Form

DRIVE Skills Basketball Training

Registration Form

1214 Turrentine St, Burlington, NC

Athlete Information

Player Name*

First NameLast Name

Age*

Guardian / Parents Names*

First NameLast Name

Address*

Street Address

Street Address Line 2

City

Postal / Zip Code

Cell Phone

Area CodePhone Number

E-mail*

Basketball skill level*

	1	2	3	4	5

1 is Beginner, 5 is Advanced

Phone Number*

Area CodePhone Number

Important Notes

· Dress appropriately.

· Keep the gym clean.

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

Fee: $160 per participant.

Includes 8 skill training sessions, twice a week.

Emergency Contact's Name*

First NameLast Name

Relationship*

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

YesNo

Please describe

4 Week Skills Training Session*

4 Week Skills Training 3rd-5th grade (Begins Monday August 5th ends Wednesday August 28th)$160.00

Registration Fee: $160 Includes 8 skill training sessions, twice a week Monday and Wednesday from 3:45 to 4:30pm

4 Week Skills Training 6th -8th grade (Begins Tuesday August 6th ends Thursday August 29th) $160.00

Registration Fee: $160 Includes 8 skill training sessions, twice a week Tuesday and Thursday from 6:00 PM- 7:00 PM

4 Week Skills Training Ladies 6th-8th grade (Begins Monday August 5th ends Wednesday August 28th)$160.00

Registration Fee: $160 Includes 8 skill training sessions, twice a week Monday and Wednesday from 6:30 PM-7:30 PM

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 4 week group program.

I have read and agree to the above conditions*

YesNo

Parent's Signature/ Child's Signature*