2020 Volunteer Basketball Clinic Registration Form
Volunteer's First Name *
Your answer
Volunteer's Last Name *
Your answer
Volunteer's Age. Must be at least 14 *
Your answer
Volunteer's Grade. Must be 8th grade and up *
Your answer
Male or Female *
School Name *
Your answer
Team/Club if volunteering as a group
Your answer
Parent/Guardian First and Last Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Parent/Guardian's Cell Phone Number (emergency contact #) *
Your answer
Volunteer's Cell Phone Number *
Your answer
Home telephone number *
Your answer
E-mail Address *
Your answer
Basketball Clinics schedule is Sundays 2/2/20 and 2/09/20 from 11:30am - 1:00 pm. Please arrive by 11:15am. Dates,time, and/or location is subject to change if needed. *
Please indicate which dates you are attending
Required
I/We give permission for my son/daughter to participate as a volunteer in the Upper Township Challenger Sports Program. I/We assume all risk of injury due to participation in this sport and release the Township of Upper and Upper Township Challenger Sports, LLC and its coaches and volunteers for any liability in this regard. I/We give permission for the Township of Upper to display my son’s/daughter’s photo. *
Parent/Guardian/or volunteer if 18 years old or over must read and acknowledge disclosure
Required
I can volunteer as *
Required
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