Basketball Stars of America Late Winter/Early Spring Program Registration Form
Name: ______________________________________________________________________
Date of Birth: ___________________________________ Age: _________ Grade: _________
School: ____________________________________________________________________
Height: ____________ Primary Position: ___________ Shirt Size: ____________ Sex: M/F
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: ______________
2010 Late Winter/Early Spring Basketball Programs: Please check all attending:
____ Sunday Basketball Boot Camps - ____# of sessions or ____8 sessions ($200)
____ Point Guard Academy - ____# of sessions or ____8 sessions ($200)
____ Post Players Academy - ____# of sessions or ____8 sessions ($200)
____ Shooting & Scoring Academy - ____# of sessions or ____8 sessions ($200)
____ Boot Camp Academy Special – 10 sessions of any for $250 (save $50)
____ Sunday Elite Player Workout with Coach Freedman ___# of sessions or ___8 sessions ($3000)
____ Presidents Day Mini Camp (Feb. 15) @ Monroeville Sports Center ____ ($60)
____ Special Boot Camps @ Shady Side Academy - ____ 2/14 ____ 2/21 ____ 2/27
____ Special Boot Camps @ Hillcrest Christian Academy - ____ 2/20 ____ 2/27
____ Special Boot Camp @ Hempfield Recreation Center - ____ 2/28
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
Call 412-400-1320 or email bsahoops@gmail.com for more information.