Student Basketball Training Application
PLEASE READ! This application must be completed in full by a parent or legal guardian. By submitting this form and providing a signature, you acknowledge that all information provided is accurate and that you have read, understood, and agreed to all policies, waivers, and program expectations outlined within this application. !!! If you do not agree with any portion of this application, please refrain from signing and contact Next Up Rising Academy for clarification before submitting.
Student Full Name
*
First Name
Last Name
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Date of Birth
*
-
Month
-
Day
Year
Date
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Email Address
*
example@example.com
Student/Athlete Email Address (if the student has one)
example@example.com
School Name
*
Current Grade/Year
*
Do you have any previous basketball experience?
*
No experience
Less than 1 year
1-3 years
More than 3 years
Other
Briefly describe your basketball experience (if any)
Do you have any medical conditions or allergies we should be aware of?
*
No
Yes (please specify below)
If yes, please specify your medical conditions or allergies
Current Medications (if any)
Allergies
Parent/Guardian Name
*
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name (Different from Parent/Guardian!)
*
Emergency Contact Phone (Different from Parent/Guardian!)
*
Minor Parent/Guardian Consent
I give permission for my child to participate in Next Up Rising training sessions, events, and related activities. I acknowledge that I have received and understand the program rules, expectations, and safety guidelines. I understand that participation in athletic activities involves physical risk, and I allow my child to participate.
Parent/Guardian Consent Signature
*
Medical Release
I authorize coaches and staff to seek medical treatment for my child in the event of an injury or emergency during training or events if I cannot be reached. I release Next Up Rising and its staff from liability for any injuries or treatment and agree to notify the program of any medical conditions, allergies, or medications that may affect my child’s participation.
Parent/Guardian Signature
*
Insurance & Risk Protection
I understand that participation in N.U.R. (Next Up Rising) Academy involves physical activity and carries inherent risks of injury. While the organization takes reasonable precautions to promote safety, I acknowledge that injuries may still occur. I understand and agree that N.U.R. Academy does not provide primary medical insurance for participants unless otherwise stated. I accept full responsibility for maintaining my child's active medical insurance coverage. In the event of an injury, I understand that any medical expenses incurred will be the responsibility of the parent or guardian.
Insurance Provider
Policy Number
Group Number (if applicable)
Insurance Status: Please check the box of the status that is appropriate.
I have provided the valid insurance information above.
My child does not currently have medical insurance.
I choose not to provide any insurance information at this time.
Other
Parent/Guardian Consent Signature
*
Photo/Video Release
I grant Next Up Rising permission to photograph, record, and use images or video of the athlete for promotional, marketing, educational, and social media purposes. I understand that no compensation will be provided for these of these materials and that they may be used indefinitely.
Parent/Guardian Consent Signature
*
Weather & Facility Closure Information
Training sessions may be cancelled or rescheduled due to severe weather, unsafe travel conditions, facility closures, or emergencies. Next Up Rising staff will communicate cancellations or schedule changes as soon as reasonably possible.
Parent/Guardian Signature
*
Transportation Liability
Parents and guardians are responsible for arranging transportation to and from all training sessions, events, and program activities. Next Up Rising staff and trainers do not provide transportation unless written permission and arrangements are approved by a parent or guardian. Next Up Rising is not responsible for athletes outside of scheduled training times, including before arrival or after dismissal from sessions.
Parent/Guardian Signature for Transportation Liability Consent
*
Athlete Code of Conduct
Athletes agree to show respect to coaches, staff, teammates, and facility personnel at all times, follow all training instructions with effort and focus, maintain positive sportsmanship and behavior, arrive on time prepared to participate, and follow all safety guidelines and program rules. Failure to follow these expectations may result in disciplinary action, including temporary or permanent removal from training sessions.
Athlete/Student Signature
*
Discipline Standards for Athlete
I understand that N.U.R. Academy is committed to developing disciplined, respectful, and accountable athletes. By enrolling, I acknowledge that my child is expected to demonstrate respect toward coaches, staff, and teammates at all times and to maintain a positive attitude and strong work ethic. I understand that athletes are expected to be coachable, accept feedback, and remain focused during all training sessions. Behavior that is disruptive, disrespectful, or unsafe will not be tolerated. I acknowledge that failure to meet these expectations may result in disciplinary action, including warning, suspension, or dismissal from the program without refund. As a parent or guardian, I agree to support the standards of the program, reinforce accountability, and communicate respectfully with staff.
Parent/Guardian Signature
*
Athlete/Student Signature
*
Parent/Guardian Code of Conduct
I understand and agree to maintain respectful communication with staff, coaches, and participants, support a positive and safe training environment, allow coaches to coach without interference, and follow all facility rules and policies. I acknowledge that failure to follow these expectations may result in removal from the facility or program.
Parent/Guardian Signature
*
Risk of Injury
I understand that participating in sports training involves a risk of injury. I choose to participate voluntarily and agree to follow all safety instructions, program rules, and guidance from coaches to help reduce the risk of injury.
Athlete/Student Signature
*
Payment Agreement
Payment is required before the start of all training sessions unless a payment plan has been approved in advance. Missed sessions without at least 24-hour notice may not be eligible for rescheduling or credit, and late arrivals will still end at the scheduled time. Payment plans must follow the agreed schedule, and failure to stay current may result in suspension of training services. Next Up Rising reserves the right to reschedule sessions due to facility conflicts, emergencies, or trainer availability.
PLEASE NOTE! The official payment due dates, and related details will be sent to each parent or guardian by email after this form has been submitted. Be sure to review that information and confirm your agreement!
Parent/Guardian Signature
*
Attendance and Refund Policy Agreement
Attendance and Participation Agreement: I understand that consistent attendance is essential to my child’s development and participation in the program. I agree to ensure my child arrives on time and is prepared for each session. I understand that repeated absences or lateness may impact participation. Refund Policy: By enrolling in N.U.R. Academy, I understand and agree that all payments are non-refundable unless otherwise stated. I acknowledge that refunds will not be issued for missed sessions, voluntary withdrawal, or dismissal due to behavioral or conduct violations. In the event of a program cancellation, any refund or credit will be determined at the organization's discretion. PLEASE NOTE! The official payment amount, due dates, and related details will be sent to each parent or guardian by email. Be sure to review that information and confirm your agreement before signing this acknowledgement!
Parent/Guardian Signature
*
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