2019 Basketball Stars of America Fall Programs Registration Form:

Name: ______________________________________________________ Date of Birth: _____________________
Age: _________  Grade: _________ School: ________________________________________________________
Height: ____________      Primary Position: ___________     Uniform Size: ____________   Sex: Male/Female
Home Street Address: ___________________________________________________________________________
City: _______________________________________________ State: ____________ Zip: ____________________
Phone Numbers: _______________________________________________________________________________
Email: _______________________________________________________________________________________
Discount Code: ____________________________________
Teammate, Coach or Number Requests: ___________________________________________________________
I understand that I am enrolling my child in the Basketball Stars of America Program or affiliated program and that the Basketball Stars of America and any affiliates, Coach Daryn Freedman, 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 or affiliated program. I also understand that my child’s picture or team picture may be used in future BSA advertising material.

Signature of Parent/Guardian:  ______________________________________________________________                  Date: ____________________

Programs: Please check all attending:

Choose The Program You Are Registering For:
____ 2019 Fall AAU Basketball Program
____ 2019 Fall In House Basketball Program
____ 2019 Fall Weeknight Basketball Skills Program
____ 2019 Fall Weekend Basketball Skills Program – Choose Skills Program Below
____ 2019 Point Park University Recruiting Showcases – Choose Showcase Below
____ 2019 Fall Basketball Mini Camps – Choose Camp Below
Choose The Location You Prefer:
____ Pittsburgh North Hills: Sports & Courts North in Wexford, PA
____ Pittsburgh South Hills: The Armory in Canonsburg, PA
____ Pittsburgh South Hills: Hillcrest Christian Academy in Bethel Park, PA
____ Monroeville: Monroeville Sports Center in Monroeville, PA
____ Pittsburgh Indoor Sports Arena in Fox Chapel Area/Cheswick, PA
____Court Time Sports Center in Elizabeth
____Point Park University in Pittsburgh (Showcases Only)
If Choosing Weekend Basketball Skills, Choose Your Skills Programs:
____ Basketball Boot Camp ____ BSA Elite Shooting & Scoring Academy ____ BSA Point Guard Academy
____ Mix & Match – ___ # of Sessions
If Choosing Point Park University Recruiting Showcases, Choose Your Dates & Showcases:
____Sunday, August 18  ____Saturday, August 31  ____Saturday, September 21  ____Sunday, September 29
____Saturday, October 12  ____Saturday, October 19
If Choosing Basketball Mini Camps, Choose Your Camps:
____Labor Day – Monday, September 2nd at Monroeville Sports Center
____Black Friday – Friday, November 29th at Monroeville Sports Center
____Thanksgiving Monday – Monday, December 2nd at Sports & Courts _____ or Monroeville Sports Center _____
____MLK Day – Monday, January 20th at Sports & Courts _____ or Monroeville Sports Center _____ or The Armory in Canonsburg ____
BSA Gear Options (Check all Ordering):
____ BSA Game Uniform Set ($100) – Includes Game Jersey, Game Shorts & Shooting Shirt – Size: _____
____ BSA Game Jersey ($35) – Size: _____
____ BSA Game Shorts ($35) – Size: _____
____ BSA Shooting Shirt ($30) – Size: _____
____ BSA Adidas T-Shirt ($15) – Size: _____
____ BSA Hoodie ($50) – Size: _____
____ BSA Sweatpants ($50) – Size: _____

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