Middle School Basketball Clinic Registration 10.10.2026

Middle School Basketball Clinic Registration 10.10.2026

Enter the participant’s details, parent/guardian contacts, and medical/emergency information, then review and sign the required waivers.
Participant Information
Participant's Full Name

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Age
Grade
School
Current Team or Club (optional)
Skill Level / Position

Other
Parent/Guardian Information
Parent/Guardian Name

First NameLast Name
Relationship to Participant
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email
example@example.com
Alternate Emergency Contact
Alternate Contact Name

First NameLast Name
Relationship to Participant
Alternate Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Alternate Contact Email (optional)
example@example.com
Emergency and Medical Information
Emergency Contact (not parent/guardian)

First NameLast Name
Relationship to Participant
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Does the participant have any allergies?
Please list allergies
Does the participant have any medical conditions?
Please list medical conditions
Does the participant require medication during the clinic?
Please list medications and instructions
Does the participant have asthma, an inhaler, or require an EpiPen?
Waivers and Consents
Photo/Video Release: I consent to photos/videos being taken for promotional purposes.
Camp Code of Conduct and Rules (PDF)
Parent/Guardian Signature
Date Signed

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Additional Comments (optional)
Payment
Clinic Fee: $25 per participant

Please pay by Cash App to $TripleThreatTrainSC. In the note, include the participant's name and "Middle School Clinic 10/10".

Tap here to pay $25 on Cash App
Registration is not complete until payment is received and all forms have been signed.
Should be Empty:

Middle School Basketball Clinic Registration 10.10.2026

Participant Information

Parent/Guardian Information

Alternate Emergency Contact

Emergency and Medical Information

Waivers and Consents

Payment