Ingersoll Athletics Youth Basketball Registration

Parent's Full Name

First NameLast Name

Parent's Email Address

example@example.com

Parent's Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Child's Full Name

First NameLast Name

Child's Date of Birth

Date

Child's Gender

Child's Grade

Medical Information & Safety Considerations

Please list any medical conditions, severe allergies, recent injuries, medications relevant to participation, or other important information our coaching staff should know to help keep your child safe during the clinic.

Select Basketball Program

Rising Athletes Basketball│Grade 5 & 6 (Friday 6pm - 7pm)

Location: Royal Roads Public School

Starting Friday Nov 13th, 3 week program

Our Recreational Basketball Program is designed for athletes looking to develop their skills, build confidence, and enjoy the game. Participants will work on fundamental skills such as dribbling, passing, shooting, and defence through engaging drills, teamwork activities, and gameplay. Whether you're new to basketball or have some experience, this program is a great opportunity to improve, stay active, and have fun!

Max 10 registrants.

$60.00 CAD

Next Level Athletes Basketball│Grade 7 & 8 (7pm - 8pm)

Location: Royal Roads Public School

Starting Friday Nov 13th, 3 week program

Our Recreational Basketball Program is designed for athletes looking to develop their skills, build confidence, and enjoy the game. Participants will work on fundamental skills such as dribbling, passing, shooting, and defence through engaging drills, teamwork activities, and gameplay. Whether you're new to basketball or have some experience, this program is a great opportunity to improve, stay active, and have fun!

Max 10 registrants.

$60.00 CAD

Subtotal

Tax

Total

Debit or Credit Card
Credit Card Number	Security Code
Expiration Month	Expiration Year

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Signature

By signing, you acknowledge that you have read, understood, and agree to the policy, Terms & Conditions and waiver.

Youth Basketball Registration

Select Basketball Program*

Select Basketball Program