DREAM Academy Registration Form

DREAM Academy Registration Form

Thank you so much for your interest in our program. DREAM Academy is more than just basketball — it’s mentorship, purpose, and growth.
🏀 Dream Academy LA – Fall 2025 Skills Training & Mentorship Clinics (Del Aire Park Hawthorne, CA)

September 22nd - November 22nd Mondays 5pm-7pm: Middle School Clinics (Grades 6–8) – Focus on advanced fundamentals, basketball IQ, and reading defenses. Tuesdays 5pm-7pm: Elementary Clinics (Grades 3–5) – Focus on fundamentals, teamwork, and confidence building. Final Event: Dream Academy Classic Tournament on November 22nd 🎉 Goals: Build a strong foundation of basketball skills through a fundamentals-first approach -Teach players to understand the game, not just play it (basketball IQ development) -Develop character, leadership, and confidence through mentorship sessions -Celebrate growth at the Dream Academy Classic Tournament, with awards for champions, leadership, teamwork, and sportsmanship.
Athlete Information
Player Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Race*
Gender
Guardian / Parents Names*

First NameLast Name
Cell Phone*
E-mail*
example@example.com
Jersey Size
Shoe Size
Basketball skill level*

1

2

3

4

5

1 is Beginner, 5 is Advanced
What grade is your child in?*
Emergency Contact Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*
Is there anything we should know about this player? *
Does you have any allergies, chronic illness, or medical conditions that would limit high level activtiy?*

YesNo
Please describe*
Important Notes
- No food or drink in the gym (except for water)
- Keep the gym clean at all times
- Return jersey daily
- Be respectful
- No cursing or foul language
- No fighting
- Follow the rules
- Do your best
- Arrive on time
- Leave on time
Pre-Survey Questions
How would you describe your child’s level of confidence?*

1

2

3

4

5

1 is Low confidence, 5 is Very Confident
How is your child doing emotionally? *

1

2

3

4

5

1 is Struggles Often, 5 is Very Well
How often does your child talk to you or someone they trust about their feelings?*

1

2

3

4

5

1 is Never, 5 is Very Often
Do you feel your child has positive role models in their life?*
What areas would you like your child to grow in (check all that apply):*

ConfidenceSelf ControlDisciplineEmotional RegulationLeadershipSocial SkillsAcademic AccountabilityNoneOther
Interested in Volunteering?*

Working the Registration TableBringing snacksSetup/TeardownDREAM PromoterNot at this time
Parental Permission For Emergency Treatment

In the event of illness or accident, I give my permission for emergency treatment by qualified medical personnel for my child.
I give consent for the facility to secure any and all necessary emergency medical care for my child.
I have read and agree to the above conditions*

YesNo
Photo/Media Release

The signer grants permission to Dream Academy LA, (and its designees and agents) to utilize the signers child’s image, likeness, actions and statements in any live or recorded audio, video or photographic display or other transmission, exhibition, publication or reproduction made of, or at, the event in any medium or context without further authorization or compensation. We, the undersigned, do hereby consent to our child’s participation in competitions and practices with Dream Academy LA.
I have read and agree to the above conditions*

YesNo
Relase of Liability

In consideration for being permitted by Dream Academy LA to participate in the above activity, I hereby waive, release, and discharge any and all claims for damages for personal injury, illness (including, but not limited to, covid-19) death, or property damage which I may have or which may hereafter accrue as a result of my participation in said activity. This release is tended to discharge in advance the above districts (its officers, employees, and agents). From and against all liability arising out of or connected in any way with my participation in said activity. I understand that the above activity of a hazardous nature and/or include physical and/or strenuous exercise or activity; and that participants in the above sport or activity occasionally sustainmortal or personal injuries and/or property damages as a consequence thereof. Knowing the risks involved, nevertheless, I have voluntarily applied to participate in said activity and I hereby agree to assume all risks of injury or death and to release and hold harmless the above districts, its officers, employees, and agents. I have read and fully understand this assumption of risk and waiver of liability and acknowledge that I have waived certain rights.
I have read and agree to the above conditions*

YesNo
Confirmation E-mail*
example@example.com
Signature*

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DREAM Academy Registration Form

🏀 Dream Academy LA – Fall 2025 Skills Training & Mentorship Clinics (Del Aire Park Hawthorne, CA)

Pre-Survey Questions