Athlete Registration Form

Athlete Registration Form

Block Work Basketball Training
Athlete Name*

First NameLast Name
Athlete Age*
Height*
School / Club Team
Are there specific skills that your Athlete would like to Develop?
Parent Guardian Information
Parent Guardian*

First NameLast Name
Parent Guardian

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

First NameLast Name
Name

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Medical Information
Allergies of Existing Injuries:*
Type N/A if None
Session Selection
LIABILITY WAIVER & RELEASE FORM
Program: DeVon Hardin Post-Play Masterclass

Trainer: DeVon Hardin

1. Acknowledgment of Risk I, the undersigned, understand that basketball is a physical sport involving risks including, but not limited to, sprains, fractures, concussions, and other serious injuries. I acknowledge that my child is participating voluntarily and I assume all risks associated with this training.

2. Release of Liability In consideration of being allowed to participate, I hereby release and hold harmless DeVon Hardin, his agents, and the facility (if applicable) from any and all liability, claims, or causes of action arising out of any injury, loss, or damage my child may sustain during or as a result of the training sessions.

3. Medical Treatment Authorization In the event of an emergency, I authorize DeVon Hardin or his staff to seek and secure necessary medical treatment for my child if I cannot be reached immediately. I understand I am solely responsible for any medical expenses incurred.

4. Photo & Media Release (Optional but Recommended) I grant permission for DeVon Hardin to use photographs or video footage of my child taken during training for promotional and social media purposes.

5. Acknowledgment of Understanding I have read this waiver in its entirety and fully understand that I am giving up substantial legal rights. I sign it freely and voluntarily on behalf of the minor athlete listed below.
Date*

MonthDayYear
Date
Media Consent Selection*
Athletes Name*

First NameLast Name
Parent / Guardian Name

First NameLast Name
Signature*

Training Options

Individual Training Voucher

A Single 1hr Training Session

$60.00

Individual Training Voucher (Cash price, $50)

A Single 1 hr Training Session (Pay In-Person)

$ Free

Multi Athlete Registration

A Single 1hr Training Session

$40.00 Quantity

Block-Buster Training Package

4 1hr. Sessions

$200.00

Block-Buster "Elite" Training Package

8 1hr. Sessions, also Includes (1) 20 Min Film Breakdown Session

$360.00

Total

$0.00

Payment Methods

Credit Card

Cash App Pay

Should be Empty:

Athlete Registration Form

Parent Guardian Information

Emergency Contact

Medical Information

Session Selection

Payment Methods