DRIVE Basketball Academy Registration Form

DRIVE Skills Basketball October Training

Registration Form

NAA Building

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

Cell Phone

Area CodePhone Number

E-mail

Basketball 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.

Fee: $200 per participant.

Includes 8 skill training sessions meeting twice a week.

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?

Please describe

My Products

Elementary School October Basketball Skills Training Session (Begins Tuesday October 6th ends Thursday October 29th) . Registration Fee: $200 Includes 8 skill training sessions, twice a week on Tuesdays and Thursdays from 3:40PM-4:30PM (October 6th - October 29th).

Elementary School October Basketball Skills Training Session (Begins Tuesday October 6th ends Thursday October 29th) $200.00

Registration Fee: $200 Includes 8 skill training sessions, twice a week on Tuesdays and Thursdays from 3:40PM-4:30PM (October 6th - October 29th).

Middle/High School October Skills Training Sessions (Begins Monday October 5th ends Wednesday October 28th). Registration Fee: $200 Includes 8 skill training sessions, twice a week on Mondays and Wednesdays from 6:00PM-6:50PM (October 5th - October 28th)

Middle/High School October Skills Training Sessions (Begins Monday October 5th ends Wednesday October 28th)$200.00

Registration Fee: $200 Includes 8 skill training sessions, twice a week on Mondays and Wednesdays from 6:00PM-6:50PM (October 5th - October 28th)

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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

Parent's Signature/ Child's Signature

My Products*

Release of Liability

My Products