H4L Enrollment Form 2026 V2

H4L Enrollment Form 2026 V2

Standard online enrollment form for player, parent/guardian, emergency, medical, program selection, payment, consent, pickup authorization, signatures, and academy use information. Organize the form as a clean, user-friendly web form and keep fields optional unless the document clearly indicates they must be required.
Player Information
Player Full Name

First NameMiddle NameLast Name
Date of Birth

MonthDayYear
Date
Age
Gender
Grade
School
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
City (Player)
State (Player)
Zip (Player)
Basketball Experience Level
Parent/Guardian Information
Parent/Guardian Full Name

First NameMiddle NameLast Name
Relationship to Player
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Address (if different from player)
City
State
Zip
Secondary Parent/Guardian Name

First NameMiddle NameLast Name
Secondary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Secondary Email
example@example.com
Emergency and Medical Information
Emergency Contact Name
Relationship to Player
Primary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Secondary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Primary Physician Name
Physician Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Health Insurance Provider
Policy Number
Known Allergies
Medical Conditions
Current Medications
Past Injuries / Physical Limitations
Special Attention Condition
If yes, explain
Program Selection
Training Only Programs
Development Program
Advanced Program
Daily Training Programs
Additional Training Options
Payment Selection
Amount Paid Today
Balance Remaining
Payment Due Dates
Payment Method

Other
Other Payment Method (specify)
Uniform Option
Uniform Size
Program and payment selections should reflect the athlete’s intended enrollment and any add-on training needs.
Select all applicable program categories and training options.
If choosing a payment arrangement, list the schedule clearly in the due dates field.
Uniform availability may vary by program; indicate preference if a separate request is needed.
Use the other payment method field only if a method not listed above is used.
Authorized Pick-Up and Release Permissions
Authorized Pick-Up - Name 1
Authorized Pick-Up - Relationship 1
Authorized Pick-Up - Phone Number 1
Please enter a valid phone number.Format: (000) 000-0000.
Authorized Pick-Up - Name 2
Authorized Pick-Up - Relationship 2
Authorized Pick-Up - Phone Number 2
Please enter a valid phone number.Format: (000) 000-0000.
Authorized Pick-Up - Name 3
Authorized Pick-Up - Relationship 3
Authorized Pick-Up - Phone Number 3
Please enter a valid phone number.Format: (000) 000-0000.
Is the player allowed to leave alone?
Consent and Acknowledgments
Consent to Participate - Parent/Guardian Initials
Emergency Medical Authorization - Parent/Guardian Initials
Assumption of Risk and Liability Acknowledgment - Parent/Guardian Initials
Photo / Video / Media Release
Photo / Video / Media Release - Parent/Guardian Initials
Payment, Attendance, and Refund Policy Acknowledgment - Parent/Guardian Initials
Code of Conduct Acknowledgment - Parent/Guardian Initials
Transportation Acknowledgment - Parent/Guardian Initials
Parent/Guardian Printed Name

First NameLast Name
Parent/Guardian Signature
Date (Parent/Guardian Signature)

MonthDayYear
Date
Player Signature (Optional Player Agreement)
Date (Player Signature)

MonthDayYear
Date
Academy Use Only
Enrollment Received By (Academy Use Only)
Date Received (Academy Use Only)

MonthDayYear
Date
Program Selected (Academy Use Only)
Payment Option (Academy Use Only)
Amount Received (Academy Use Only)
Start Date (Academy Use Only)

MonthDayYear
Date
Notes (Academy Use Only)
Should be Empty:

H4L Enrollment Form 2026 V2

Player Information

Parent/Guardian Information

Emergency and Medical Information

Program Selection

Authorized Pick-Up and Release Permissions

Consent and Acknowledgments

Academy Use Only