Thanksgiving Skills Clinic registration form

Report
presents
Clinic Details
Saturday, November 22nd , 2014
Greenfield HS
1 Lenox Ave, Greenfield MA 01301
Clinic Director: Angelo Thomas
Boys & Girls
Grades 1st – 3rd : 10:00 a.m. – 12:00 noon
Grades 4th – 6th : 12:30 p.m. – 2:30 p.m.
Grades 7th – 12th : 3:00 p.m. – 5:00 p.m.
Cost: $35 in advance; $40 day of clinic
Registration/ Sign-in begins 30 minutes before each clinic
Participation waivers must be signed day of clinic
www.drivehoopsbasketball.com
REGISTRATION FORM
Participant Name:_______________________________ DOB:_______ Grade: ____
Parent/Guardian Name: _______________________________________________
Address: ___________________________________________________________
City: ___________________________________ State: ______ Zip: ___________
Day Phone: __________________________ Home Phone: __________________
Email: ____________________________________________________________
Signature:__________________________________________________________
PLEASE MAKE CHECKS PAYABLE TO: DRIVE Hoops
Mail registration form & payment to: DRIVE Hoops, 5 Verde Drive, Greenfield MA 01301
T –shirt size (size limited to availability) S M L XL
Special guest instructor
Ben Barshefsky of
Top Notch Basketball

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