SportsEngine Registration: Hotshots Athletics Basketball Academy

Free Basketball Training Session

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CONGRATULATIONS!

On taking the first step towards improving your skills, becoming a better athlete and in gaining confidence !

All we need now is to know a little bit more about you so please fill out this questionnaire and one of our trainers will contact you to set up your free session.

Athlete Information

First Name:*

Last Name:*

Birthdate:*

Age:

School Name::

Grade::

Basketball Experience:

Parent/Guardian First Name:*

Parent/Guardian Last Name:*

Email:*

Parent/Guardian Phone Number:*

Parent/Guardian Phone Number 2:

Address 1:*

Address 2:

City:*

State:*

Zip:*

Emergency Contact First Name:*

Emergency Contact Last Name:*

Emergency Contact Phone Number:*

Emergency Contact Relationship to Participant:*

Medical Insurance Company:*

Medical Insurance Group Number:*

Medical Insurance Policy Number:*

Medical Insurance Policy Holder:*

Medical Conditions: