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IMPACT Elite Training Program 2019 Registration Form
Please complete this online registration form and forward a completed cheque made payable to
"IMPACT Sports Academy Ltd" to
Unit 3205, 32/F,
W50, 50 Wong Chuk Hang Road,
For any enquiries please contact IMPACT Basketball at
IMPACT Basketball Elite Skill Development Program! Join our weekly training to elevate your game throughout the school term.
Get better everyday with our high intensity training program designed by Coach Tyler Kepkay
Period: Jan 15 to Apr 30, 2019. Every Tuesday at 6:30 to 8pm in Middle School Gym, HKIS, Tai Tam. One session per week* -- Program fee: $4,000
*Public Holidays excluded.
Please select your age group
Student's First Name
Student's Last Name
Date of Birth
Parent #1 Name
Parent #1 Mobile Number
Parent #1 Email Address
Parent #2 Name
Parent #2 Mobile Number
Helper Mobile Number
Does your child suffer from any allergies? If yes please specify and give medication details
By submitting this form I agree that my child will abide by the rules and regulations. I will not hold HKIS and IMPACT Basketball Academy or their employees responsible for any injury to my child, or damages to property as a result of participation in the course.
By submitting this form I agree that 50% of the payment will be made to IMPACT Sports Academy Ltd if my child is unable to attend in the program.
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