ICLI Basketball Performance Training Sessions Registration Form
Boys Only (Grade 5-10) Starting March 4th ( 5 sessions only) 1:30 - 2:45 p.m.
Email address *
Parent's First Name *
Your answer
Parent's Last Name *
Your answer
Home Address *
Your answer
City *
Your answer
State *
Your answer
Zip code *
Your answer
Home Phone Number *
Your answer
Cell Phone Number *
Your answer
Which phone number is the best to contact you? *
Your relation to participant *
Emergency Number *
Your answer
Child's First Name *
Your answer
Child's Last name *
Your answer
Child's Age *
Your answer
Child's date of birth *
Your answer
Child's Grade *
List any health problems and/or allergies that can/will affect performance: List & Explain *
Your answer
School your child attends *
Your answer
Are you an ICLI member? *
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