Adult 16+ Pickup Basketball 25-26 Registration Form
Please complete ONE FORM PER PARTICIPANT.  You must hit submit at the end of the form. 

If you don't get a confirmation message immediately after, your registration did not go through, and WRC might not be able to take the registration late.
  • Ages 16+
  • October - January (fall session) & February - June (spring session)
  • Wednesdays  7:00 to 9:00 pm @ Westford School Gym
  • START DATE September 17, 2025
  • $5 drop in, $30 for fall session, $30 for spring session, or $50 for both sessions
No matter what method you use to pay for this program, you MUST include the participant name and program you are paying for, or your payment will not be directed to the correct line-item and will be considered a donation to WRD.

Forms that are not properly completed will be deleted and you will be asked to fill it out again, if that happens at the registration deadline, your registration might be late. 

If you need help submitting this form, have questions, or would like to request more information, please email us at recreation@westfordvt.us

Thank you, Westford Residents (and residents in nearby towns) for your participation in our programs.  We appreciate you and look forward to seeing you enjoy this event!

Westford Recreation Board
Email *
Scholarship Fund:  If your financial situation is preventing you from signing yourself or your child up for this activity, please write a brief statement of need.  The Recreation Department Committee will review eligibility for a scholarship & contact you.
Participant's Full Name *
Session
 *
Email Address to be used for program communication
 *
Primary Mailing Address *
Primary Phone # *
Emergency Contact Name & Phone Number, hopefully someone different from the person listed above.
 *
Please List medical conditions of the participant, physical limitations, allergies, or restrictions WRD should be aware of.
*
Release/Waiver Agreement: I am fully aware of the inherent risk, and give my consent for the above named participant to participate in the program listed above.  I hold harmless the Town of Westford, Westford School, their employees, elected officials, and/or any volunteers or instructors from any and all liability from any injury, claim, costs or loss of services which may be incurred by me, or us, or our minor children on account of participation in said program.  Permission is hereby granted for me or my child to receive emergency treatment if needed and I authorize the attending physician to administer any needed medical attention.  Furthermore, I certify that I, or my child, am/is in good health and that there are no limitations to my/their participation except as documented above.  I have read this document carefully and sign it voluntarily with full knowledge of its significance.  

By clicking "agree" below, I release the Westford Recreation Department from all liability relating to injuries that may occur. 

Typing my name on the Other line is my signature to this release (a parent/guardian must sign for participants under 18)
 *
Photo Release: I give the Westford Recreation Department permission to photograph and use myself/my child's image in its publications or on social media. *Participant's name will NEVER be included with any image.

You must check Yes or NO.

Typing my name on the Other line is my signature to this release (a parent/guardian must sign for participants under 18)
*
If you are not feeling well or are sick, please do not participate. If you have had a temperature over 100.4°F and/or you have vomited in the past 12 hours, DO NOT attend the program.

Health Agreement: To ensure the health and safety of all participants, volunteers, and their families, I agree to the following:  A personal health check will be completed BEFORE participating in any Westford Recreation Department program.

You must check agree to participate.

Typing my name on the Other line is my signature that I agree to the Health Agreement (a parent/guardian must sign for participants under 18)
*
Are you interested in donating to the Scholarship Fund? If so, please select an amount.
Fee can be paid via card, cash or check or, if necessary Venmo (if Venmo, please see these instructions!).  Make checks payable to: WESTFORD RECREATION DEPARTMENT. 

Program and participant name MUST be included with payment!

I will submit payment via:

*Requesting a scholarship (Please answer the first question)

*Online *Program fee(s) + $3 Processing fee*:
Reference Number = PROGRAM NAME & Partipants(s) Name
HIT SUBMIT BUTTON DOWN BELOW FIRST BEFORE PAYING THIS WAY!
Then come back to this webpage and follow this link to pay:

*Mail to: Town of Westford, 1713 VT Rt. 128 Westford VT 05494
PLEASE NOTE Your Name and "Adult pickup basketball" in the memo line

*Leave in the Drop Box at the Town Office
PLEASE NOTE Your Name and "Adult pickup basketball" in the memo line

*Venmo (see instructions above)
 *
A copy of your responses will be emailed to .
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