FLYIN' J's » Registration

Basketball Skills Development

Building smart players, one skill at a time…

Registration

Fields with * are required.

Player's Info

	First Name*
	Last Name*
	Gender*	Male Female
	Returning to FLYIN' J's?*	Yes No (New)
	Address*
	School*
	Current Grade*
	Player is vaccinated?*	Yes No

Parents' Info

	Father's Full Name*
	Father's Phone Number*

	Mother's Full Name
	Mother's Phone Number

	Primary Email*
	Secondary Email

	Emergency Phone Number*

Background and Expectations

How did you hear about FLYIN’ J’s? If from a person, please specify the name(s) so I can thank them.
What do you and/or your son/daughter expect to learn from this program?
Is your son/daughter currently playing in a basketball league? If so, where?
Other comment/notes that you like to share with us:

Terms and Conditions/Waiver

Participation in the basketball training and league may involve risk of injury. As a parent or guardian, I
attest and verify that I have full knowledge of the risk. I hereby give my consent for my child to
participate in FLYIN’ J’s basketball clinic and other activities. I understand basketball, at times, can be a
physically demanding and dangerous sport. I declare my child is in good physical condition and is able to
meet these physical demands, and will not, under any circumstances, hold the club and its coaches liable
for any injuries incurred during the activities. In addition, I give permission for my child to be treated, if
needed, by qualified medical personnel in the event that I cannot be reached at the phone numbers
provided.

I also give permission for photographs of my child to be published on FLYIN’ J’s website and publications.

This registration is valid for the FLYIN' J's 2021 season.

Confirm Registration

*By checking this box, I verify that the information provided is accurate. I also agree to the terms and conditions above.

Please sign by entering your full name* :

Validation Code:

Please re-enter the validation code here: