Mustangs Clinic Registration Form (2026 FALL)

Clinic Registration Form

Fall Clinic: Sat 10/03/2026
Clinic Date: 10/03/2026
Clinic Time: PreK-K 3:00-4:30pm | 1st-2nd 4:00-6:00pm
Location: Elder Park Gym, 1950 Wilcox Ave, Monterey Park, CA 91755

Please fill out a separate Registration Form and Waiver for each child attending.

At this time, we are only accepting boys and girls enrolled in Pre-K through Grade 2. The cost is $0 for each child.

Remember to bring water and a basketball. Your child should be in comfortable clothing & sneakers. (No open-toe shoes or sandals)

If you have questions, please email us at MustangsClinics@gmail.com.

If your child is currently rostered under another CYC/JAO organization, we request that you do NOT complete registration but rather contact your current CYC/JAO basketball organization to confirm eligibility for participating in this Mustangs clinic.
Player Name (Full Name of Minor)

First NameLast Name
Player Gender
Player Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Player Grade
Player School
Player Ethnicity (Select all that apply)
Player Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent / Legal Guardian 1 NAME

First NameLast Name
Parent / Legal Guardian 1 NUMBER
Format: (000) 000-0000.
Parent / Legal Guardian 1 EMAIL
Parent / Legal Guardian 1 RELATIONSHIP
Parent / Legal Guardian 2 NAME (If single parent, type in "N/A")

First NameLast Name
Parent / Legal Guardian 2 NUMBER
Format: (000) 000-0000.
Parent / Legal Guardian 2 EMAIL
Parent / Legal Guardian 2 RELATIONSHIP
WAIVERS AND RELEASES
HOLD HARMLESS AND INDEMNIFICATION AGREEMENT
PERMISSION TO USE OF NAME AND LIKENESS FOR PUBLICITY & DISPLAY OF IMAGES ON THE MUSTANGS WEBSITE AND OTHER MEDIA
MEDICAL AUTHORIZATION
Info for Medical Emergencies
Online Registration Acknowledgment

I/We certify that all provided information is correct and true. If any of the submitted information is found to be incorrect or untrue, this will deem this registration form invalid and will have to be re-submitted online for approval.
Parent/Legal Guardian 1 SIGNATURE
Signature Date
Please verify accuracy of information noted in this waiver.
Then click "Submit Waiver" below.
Should be Empty:

Clinic Registration Form

Online Registration Acknowledgment