Purchase

Please fill out this waiver form and click on the Submit button at the bottom to finalize your purchase with your credit card.

Package : 3 Lessons Save 5%
Package Amount : $139.00

Student / Athletes Information

Name *

Gender   Male      Female  

Grade *

Age *

Height

Home Address

Same for Billing Address.

Home City

State

Zip Code

Parent Information

Parent’s First Name

Parent’s Last Name

Home Phone

Parent’s Cell

Email Id *

 Waiver of Claims : *

I, as a parent or guardian, hereby give permission for my child to participate in basketball training by HBC, LLC. I acknowledge the fact that he/she is physically able to participate in physical activities. I hereby authorize the directors and coaches of Hoops Blessing LLC. to act for me according to their best judgement in an emergency requiring medical attention. I acknowledge that I will bre responsible for any cost (through family medical insurance or otherwise) incurred due to sickness or injury to my son or daughter. I hereby waive any claim I might have against Hoop Blessing LLC., its members and coaches.

Signature *