2023 CCHS Girls Basketball Youth Clinic

2025 CCHS Girls Youth Basketball Clinic

REGISTRATION FORM
Join CCHS Girls Basketball Coach Cohen, CCHSassistant coaches and CCHS varsity players on Sat 08 Feb 2025 at CCHS a clinic for girls in grades 1-8. Participants will work on their game in a supportive environment and have a chance to hone their skills.

The clinic provides important fundraising support for CCHS Girls Basketball, with all proceeds going to the program.
- COST: $60
- WHERE: Concord-Carlisle High School, Main Gym
- WHEN: Sat 08 Feb 2025, 11:00am - 2:00pm
Player Information
Player Name*

First NameLast Name
Player Grade*
Never played basketball beforePlayed informally/attended clinicsPlayed for a travel or school teamPlayed club basketball
Parent/Guardian information
Parent/Guardian Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Parent/Guardian (2) Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Emergency Contact/Medical Information
Emergency Contact Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Allergies/medical alerts for your player (please write "none" if none)*
Does your player carry an inhaler or EpiPen? Please provide instructions below if so.
I agree
Waiver/Release
I understand that participation in this event by the child listed above ("Player") involves a certain degree of risk that could result in injury, death or loss or damage to a person or property.

On my behalf and on the behalf of the Player, and our heirs, successors and assigns, I release, discharge and covenant not to sue Concord Public Schools, Carlisle Public Schools, Concord-Carlisle Regional School District, CCHS Girls Basketball, Friends of CCHS Girls Basketball, Inc., and their employees, officers, directors, agents, volunteers, students and members, from any and all liability, claims, costs, demands or causes of action, for injuries or damages arising out of Player’s participation in this event. I further agree that if, despite this Waiver and Release, the Player or I, or anyone on our behalf, makes such a claim against any of the Released Parties, I will indemnify, save and hold harmless each of the Released Parties from any litigation expenses, attorney fees, loss, liability, damage, or cost which may be incurred as the result of such claim.

I consent to the use of photographs/videotape of Player taken during the course of the Activity for publicity, promotional and/or educational purposes (including publications, presentation or broadcast via newspaper, internet or other media sources).

I agree that my electronic signature below shall have the same validity and effect as my handwritten signature.
Signature*
Payment/Finalizing Registration
PayPalCheck/Cash
PayPal Form
Purchase Order Form
Should be Empty:

2025 CCHS Girls Youth Basketball Clinic

Player Information

Parent/Guardian information

Emergency Contact/Medical Information

Waiver/Release

Payment/Finalizing Registration