Basketball Training Sessions Intake Form

1

Player's Name* This field is required.

First Name

Last Name

2

Player's Age

3

Gender* This field is required.

Female

Male

4

Height* This field is required.

ft

5

Weight* This field is required.

lbs

6

Parent's Phone Number* This field is required.

Please enter a valid phone number.

7

Parent's Email* This field is required.

example@example.com

8

Any health problems we should know about?* This field is required. Type N/A if none

9

Which of the following statements aligns with your goals?* This field is required.

Learn the fundamentals

Make a school/AAU team

Improve shooting ability

Become a better passer

Become a better defender

Improve game IQ

Other

10

How often do you play/practice?* This field is required.

11

How often do you want lessons?* This field is required.

Once a week

Twice a week

Once every two week

Other

13

Do you have an Irving Parks and Recreation ID Card* This field is required.

Yes

No

No, but willing to get one!

14

Are you okay with practicing outside?* This field is required.

Yes

No

15

Do you have a basketball hoop at home and would like to practice there?* This field is required.

Yes

No

Other

16

Who is your favorite player / team?* This field is required.

17

Would you be interested in Gameplay Analysis / Coaching on in-game video? Ex. (Hudl Clips, game film..)* This field is required.

Yes

No