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2026 Kernel Klub Girls' Basketball
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First and Last Name of athlete *
Current Grade *
Current School Attending *
Parent #1 First and Last Name *
Parent #1 Email Address *
Parent #1 Cell Phone Number *
Parent #2 First and Last Name *
Parent #2 Email *
Parent #2 Cell Phone Number *
Does your child need transportation after school, by bus, to the middle school gym?   *
Are there any medical concerns to be aware of at this time? Say "No" below, or explain in detail.  *
I acknowledge and consent to my child's participation in the Kernel Klub program organized by the Mitchell School District. I understand and accept the inherent risks associated with this activity and willingly release the Mitchell School District and its coaches from any liability, claims, or demands arising from my child's participation in the program. I affirm that I understand the terms and conditions of this physical activity. *
I agree to pick-up my child by 5:00pm at the designated location from all practices and games during this four week Kernel Klub session. *
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