Program Registration Form

Program Registration Form
Email*
example@example.com
Name of Event*
Participant's Name*
Gender*

MaleFemaleOther
Race*

American Indian or Alaska NativeAsianBlack or African AmericanHispanic or LatinoNative Hawaiian or Pacific IslanderWhiteOther
Date of Birth*

MonthDayYear
Parent/Guardian Name*
Home Address*
Phone*
Please enter a valid phone number.
Alternate Number*
Please enter a valid phone number.
Any medical conditions or food allergies?*
Emergency Contact Number*
Please enter a valid phone number.
School*
Grade*
T-Shirt Size*

XSSMLXLXXL
THE PARENT/GUARDIAN OF THE ABOVE NAME CHILD, HEREBY GIVE MY APPROVAL OF HIS/HER PARTICIPATION IN ALL BASKETBALL/SPORTING ACTIVITIES. I ASSUME ALL RISKS AND HAZARDS INCIDENTAL TO SUCH PARTICIPATION. I DO HEREBY WAIVE, RELEASE, ABSOLVE AND AGREE TO HOLD THIS FACILITY AND BE A NINTH WONDER FOUNDATION, INC, COACHES AND OFFICIALS FROM ANY CLAIMS WHICH MIGHT ARISE FROM INJURIES SUSTAINED WHILE PARTICIPATING IN THIS EVENT. PICTURES AND VIDEOS WILL BE TAKEN DURING EVENTS. THEREFORE I/WE THE PARENT/GUARDIAN OF THE ABOVE NAME PARTICIPANT, GIVE BE A 9TH WONDER FOUNDATION PERMISSION TO USE THE ABOVE NAME PARTICIPANT’S PICTURE AND OR VIDEO ON WEBSITES (SUCH AS FACEBOOK, INSTAGRAM OR OTHER SOCIAL MEDIA ENTITIES) TAKEN DURING TRAINING SESSIONS,CAMPS OR WORKOUTS FOR PROMOTION PURPOSES ONLY.*

CHECK HERE IF YOU AGREE
For grant purposes, please indicate your household income*

Below 30,000 annually31,000-50,000 annuallyAbove 51,000 annually
Please read and agree COVID-19 Safety Acknowledgement And Liability Waiver https://ninthwonder.org/covid-19-safety-acknowledgement-and-liability-waiver/*

CHECK HERE IF YOU AGREE
A copy of your responses will be emailed to the address that you provided.
Should be Empty:

Program Registration Form

A copy of your responses will be emailed to the address that you provided.