Instructional Basketball Clinic

This clinic’s main objective is to provide basic level fundamental instruction for kids age Pre-K through 8th grade. Fundamentals include dribbling with both hands, proper shooting form, proper passing techniques, terminology, and much more!

Instructional Basketball Clinic

Fill out the Form below to sign up for our Instructional Basketball Clinic.

Dates: Saturdays, Dec 10 & 17, 2022

Age Groups: Pre K- 2nd Grade (9-10:15am), 3rd- 5th Grade (10:30-12pm), 6th- 8th Grade (12:15-1:45pm)

Child Name:(Required)

Address:(Required)

Date of Birth:(Required)

Parent Email ID:(Required)

Grade Level:(Required)

Current Age:(Required)

School Attending:(Required)

Name of Parent/Guardian:(Required)

Parent/Guardian Phone Number:(Required)

Secondary Emergency Contact Name:(Required)

Secondary Emergency Contact Phone Number:(Required)

Child Skill Level:

Participation/Liability Release(Required)

I give my permission for the above-named child to participate in the Wood County Recreation Commission Instructional Basketball Clinic. It is clearly understood and agreed upon that the WCRC, any program sponsor, and/or all persons connected with the program will not be held liable in the event of an injury to the above-named child. In the event of an injury, I hereby agree to allow pertinent medical information about the above-named participant to be shared with any medical professional that may treat or respond if an injury shall occur.

Parent/Guardian Signature(Required)

Date

Photographic Image Release(Required)

The above-named participant and their legal parent/guardian grant full permission to the Wood County Recreation Commission (WCRC) to use, duplicate, broadcast, and/or publish photographic images for the purpose of promoting WCRC programming. Furthermore, the above-named participant and/or their legal parent or guardian by affixing their signature upon this document thereby claim no other liability to WCRC for the use if the above-named participant's photographic image/likeness.

Parent/Guardian Signature(Required)

Date

Parent/Guardian Special Notes or Comments:

Payment Form

Payment

Price:

The price mentioned is per Child. If you have multiple children to sign up, please submit this form and then fill it out again for each child.

Coupon

Total

Credit Card

Card Details

Cardholder Name

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