Participant Name *
Participant Name
Gender *
Participant Home Address *
Participant Home Address
Participant Cell Phone (if applicable)
Participant Cell Phone (if applicable)
Parent's Cell Phone *
Parent's Cell Phone
Parent must be able to be reached on this number at anytime.
Specify any of your child's health problems and/or allergies. Please list any medications your child is currently on?
Member Package *
Needs Improvement
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Photo Consent *
Form of payment *
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I hereby state that (athlete's name)_________________________________ is in good mental and physical health condition to participate in the training provided by T2S Basketball Academy including but not limited to all aspects of running, jumping and or supervised /controlled competition. I am fully aware that any activity involving athletic activity creates the possibility of serious injury. I hereby release T2S Basketball Academy, its employees and its staff from liability to the above named athlete, of the person claiming through him/her, arising from injury to the person or property of the above named athlete occurring in the following premises: of Roosevelt Elementary School, Grant Elementary School, Thomas Jefferson Early Learning Center and/or Ridgefield Park Town Courts including any event sponsored or sanctioned by T2S Basketball Academy.