Player Information Form
Please Note -
Junior & Senior registration is
Indicates required field
Grade for 2015-2016 School Year
Parent or Legal Guardian Name
Alternate Phone Number
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.
Yes, I have read and acknowledge and agree to the terms of the Consent, Waiver & Release.
submit and continue to checkout