ShootingLAB

Athlete #1 First & Last Name: *

Age: *

Grade: *

School:

Address: *

City: *

State: *

Zip Code: *

Primary Parent: *

Phone: *

Email Address: *

Secondary Parent:

Phone:

Email Address:

Emergency Contact: *

Phone: *

Additional adult(s) and/or person(s) authorized to pick up child:

Please list any allergies: *

PLAYER QUESTIONNAIRE

How much to do you love shooting during the game? *

How often do you practice/work on your shot? *

What do you feel needs the most work with your shooting? *

What's your ultimate goal as a basketball player? *

REGISTRATION OPTIONS

SPRING TRAINING DATES:

April 7TH - May 19TH

Grades: 4th & 5th 4:00pm - 5:00pm

Grades: 6th - 8th 5:00pm - 6:00pm

SELECT SESSION:

SUMMER TRAINING DATES:

SESSION #1: JUNE 17-21

SESSION #2: JULY 8-12

SESSION #3: JULY 29-AUG 2

*SUMMER SESSIONS OPEN TO GRADES 5-9*

SESSIONS ARE LIMITED TO 5 ATHLETES – SESSIONS MEET FROM 4:30-5:30PM

FOUR SESSIONS PER WEEK [MON-THURS]

SELECT SESSION(S):

Session #1 - June 17-21

Session #2 - July 8-12

Session #3 - July 29-Aug 2

MOMENTUM³/TheLAB((3)) RELEASE INFORMATION

CANCELLATIONS, REFUNDS & MAKE-UPS:

Momentum³ & TheLAB((3)) reserves the right, prior to the start date or after, to cancel a course due to insufficient registration with full refund.
There is an $80 non-refundable deposit included in the price of all week long camps (Winter, Spring, & Summer), if requested 14 days prior to camp. After camp start date, no refunds will be issued.
There is a $30 non-refundable deposit included in the price of all mini-camps and clinics, if requested 14 days prior to camp. $35 if re- quested less than 14 days prior to camp. After the program start date, no refunds will be issued.
Requests for program fee refunds (not including the non-refundable registration fee and fee for any days attended) will be considered. Please allow 2-4 weeks for processing.
Camp, clinic, or training fees are not transferable.

MEDICAL RELEASE AND ASSUMPTION OF RISK: (For any student participating in any class)

By the very nature of sports, Momentum³/TheLAB((3)) programs carry a risk of physical injury. No matter how careful the participant and the coach are, the risk cannot be eliminated. The risk of injury includes minor injuries such as bruises and more serious injuries such as broken bones, dislocations and muscle pulls. Momentum³/TheLAB((3)) is bound by law to inform all participants and/or their guardians of the risk involved in participation in its’ sports programs. Anyone participating in a Momentum³/TheLAB((3)) program must sign the notice on the application, and adhere to the safety rules. These rules will be covered on the first day of camp or class and will be revisited throughout the program. In consideration for Momentum³/TheLAB((3)), acceptance of the applicant, and in consideration of the applicant’s opportunity to improve skills through the use of the Momentum³/TheLAB((3)) staff, equipment and facilities in use, those legally responsible for the name enrolling student realize the risk of injury involved and hereby agree to assume the responsibility of such said athlete and further agree to save and hold harmless Momentum³/TheLAB((3)), its employees, and all others concerned, and to indemnify them against loss, intending to be legally bound.

I certify that the enrollee has no condition that prohibits full participation in the activities during Momentum³/TheLAB((3)) programs. I assume all risks while my child is enrolled and hereby release Momentum³/TheLAB((3)), or any of its employees, for any injury or damage suffered in connection with the aforementioned, Momentum³/TheLAB((3)), and its equipment. In case of emergency, if I cannot be reached, I authorize Momentum³/TheLAB((3)), its agents and employees, to contact and secure necessary medical attention for my child.

Parent/Guardian Name: *

Date: *

Parent/Guardian Signature: *

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