Basketball Clinic Registration Template

2026 Highland Springs Girls Basketball Clinic Registration
The Highland Springs Girl's High School Basketball Program invites all rising 3rd- 8th grade girls to come enjoy a great summer basketball clinic.

Each camper will learn from coaches and players in the Highland Springs program, receive individual skills to work on and participate in team activities that build their knowledge of the game, all while enjoying a fun and safe environment!

CAMP FEATURES:
- Campers will get to know and learn from coaches and players from the Girls' basketball program!
- Contests and games with Awards given at the end of the week!
- Positive, Fun Environment for everyone!

Basketball Clinic Details:

DATES: Saturday , May 30th, 2026

Time: 9:00 AM - 12:00pmPM (Drop-off begins at 8:30, Pick-Up ends at 12:15pm )

What to bring: Water Bottle, basketball shoes

LOCATION: Highland Springs High School

200 S Airport Dr
Highland Springs, VA 23075
United States

COST: Free
Athlete Information
Athlete's Name*

First NameLast Name
Campers Grade level for the 2025-26 school year*
Campers Age as of May 30,2026 *
Gender*

Female
Campers T -Shirt Size
Parent/Guardian Information
Name*

First NameLast Name
E-mail*
example@example.com
Home Number
Format: (000) 000-0000.
Cell Number*
Format: (000) 000-0000.
Emergency Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*
Format: (000) 000-0000.
Alternative Phone Number
Format: (000) 000-0000.
Allergies? (Please list)
Format: (000) 000-0000.
Medical Conditions? (Please list)
Format: (000) 000-0000.
Is the athlete prescribed an inhaler?

YesNo
If yes, please explain any instructions.*
Informed Consent and Acknowledgement ( Highland Springs Girl's Basketball)

I hereby give my approval for my child’s participation in any and all activities prepared by this organization, during the selected Basketball clinic. In exchange for the acceptance of said child’s candidacy by this organization. I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless this organization. All its respective officers, agents, and representatives from any and all liability for injuries to the said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against the organization. Including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including basketball. Some of these injuries include but are not limited to, the risk of fractures, paralysis, or death.

Highland Springs High School/Highland Springs Girl's Basketball Team is not responsible for for stolen items, injury or etc!
Confirmation

By acknowledging and signing below, I am delivering an electronic signature that will have the same effect as an original manual paper signature. The electronic signature will be equally as binding as an original manual paper signature.
E-Signature*
Should be Empty:

2026 Highland Springs Girls Basketball Clinic Registration

Athlete Information

Parent/Guardian Information

Emergency Information