home
About Drive5
Contact
Player Information Form
*
Indicates required field
Player Name
*
First
Last
Grade for 2016-2017 School Year
*
Select One
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
Freshman
Sophomore
Junior
Senior
[object Object]
Gender
*
Male
Female
Parent or Legal Guardian Name
*
First
Last
Phone Number
*
Alternate Phone Number
*
Email
*
A Player or Parent / Legal Guardian (if player is under the age of 18) must acknowledge and agree to the terms of the
Consent, Waiver & Release
before the player may participate in any activities at Pursuit Basketball Academy.
Acknowledgement
*
Yes, I have read and acknowledge and agree to the terms of the Consent, Waiver & Release.
submit and continue to checkout