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RVCBL - Hoops for All Participant Registration
Rockville Centre Special Needs Basketball Clinic
Location: RVC Rec Center (111 N. Oceanside Rd)
Grades 3-8 - 9:00am-10:00am
Grades 9-12 - 10:00am-11:00am
ONE FORM PER PARTICIPANT
(Volunteers should use Volunteer Registration Form)
SECTION 1 - PARENT/GUARDIAN INFORMATION
Name
*
First
Last
Cell Phone
*
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Email
*
Participant Information - Separate form for each participant
Name
*
First
Last
School
*
Shirt Size
*
Please select
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Grade (number only)
*
Would like to participate on:
Sunday, January 11
Sunday, January 25
Sunday, February 8
Sunday, February 22
Sunday, March 1
Please indicate what, if any, assistance your child may need or any special conditions we should know.
Signature:
By signing and submitting this permission slip, you agree that your child is in good medical condition to participate in this clinic.
*
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