Basketball Training Registration Form
Registration Fee: $25. (Payment Methods: CashApp, Zelle, Venmo, Cash)
For questions or additional info, contact Coach Damien McClain at dmcclai@yahoo.com or 704-562-7934. If you are registering more than one child, please fill out a separate form. Thank you.
Participant's Full Name
*
First Name
Last Name
Parent/Guardian's Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Participant's Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Student's Grade
*
2nd
3rd
4th
5th
Registering more than one child?
*
Yes
No
Emergency Contact Information
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Medical Information
Do you have questions or concerns?
Submit
Should be Empty: