Top Flight Basketball
Basketball Academy

Registrations Form






*Registration Form ID :

 
     
*Registration Date :    
       
*Player First Name : *Player Last Name :
     
 Nick Name/ Alias: *Date of Birth :
     


   
*Gender *School *School Name
(Can Key only If Other)		 Player Mobile Phone
(if any)
Player Email
(if any)		 Height in c.m. Skill Level


Required Main Contact Person:

*Name of Main Contact Person *Relation to Player *Mobile Phone
*Email Home Phone Office Phone


Main Contact Postal Address:

Address Line 1 Address Line 2
Province Postal Code


Optional Second Contact Person:

Name of Second Contact Person *Relation to Player (req. if name) *Mobile Phone (req. if name)
*Email (req. if name) Home Phone Office Phone



Coure Registration Section :

*Course Code :
   
*Course Name :
   
Course Type Code :  
   
Course Type Name :
   
Course Description :
   
*Schedule Description :
   
   


*Location Gender *Age Range *As Of Date for Age
From To
*Course Start Date *Course End Date *Registration Open Date *Registration Close Date  
 


No. Hrs.
Per Week		 No. Weeks Total Hours *Course Price Allow Per Session ? Price Per Session

 


*Type of Registration :            Your Cost : 
   
*Discount Notes :
   
Note to Academy Staff :
   
Waiver Statement :
  *I Agree