Basketball Stars of America Winter Program Registration Form

Name:                                                                                                         Date of Birth:

Age:                          Grade:                       School:

Height:                       Primary Position:                    Shirt Size:                   Sex: Male/Female

Home Street Address:                       

City:                                                                                          State:                                                      Zip:

Phone Numbers:                       

Email:                       

Waiver: I understand that I am enrolling my child in the Basketball Stars of America/Pittsburgh AAU Program and that the Basketball Stars of America, Coach Daryn Freedman, Hoop Mountain PA, Sewickley Academy or any coaches or facilities used will not be liable for any injuries incurred during participation in the program. I also understand that there are no refunds! If a player is injured and can't continue, he or she will receive a prorated credit towards another BSA program.


Signature of Parent/Guardian:                                                                                                       Date:

2009 Winter Basketball Programs: Please check all attending:

____ Sunday Basketball Boot Camps - ____# of sessions or ____10 sessions ($250) or ____ All 18 sessions ($350)

____ Winter AAU Basketball Leagues - ____NIT ____NCAA ____NBA East ____WNBA 

____ BSA Academies - ___ PG Academy ___ Shooting & Scoring Academy ___ Post Players Academy

____ Sunday Elite Player Workout with Coach Freedman ___# of sessions or ___10 sessions ($450)

____ Speed, Quickness & Basketball Strength Training ___# of sessions or ___10 sessions ($300)  

____ Thanksgiving Camp (Nov. 27-28) @ Monroeville Sports Center - ___1 Day ($60) or 2 Days ($100)

____ Holiday Camp (Dec. 28-30) @ Monroeville Sports Center - ___1 or 2 Days ($60/day) or 3 Days ($150)

____ New BSA Jersey ($25)  

Please mail completed registration form along with a check made out to: Basketball Stars of America LLC To: Basketball Stars of America LLC, c/o Coach Daryn Freedman, 547 Burkes Drive, Coraopolis, PA 15108