New Member Try Your First Lesson for $1 Name* First Last Student Cell* Age of Student* Birth Date* Grade* Home Phone* Address* Street Address City ZIP Code Father's Name*Father's Cell #*Father's Email*Mother's Name*Mother's Cell #*Mother's Email*What do you want your child to improve upon the most?*Permission (Parents Signature)* ______________has my permission to participate in the SCORE camp, I, as the undersigned, here by release and hold harmless the coaches, SCORE, and any associated sponsors from any and all claims and liability for personal injury arising from participate in all activites and authorize any neccessary medical, diagnostic/hospital procedure as may be performed or prescirbed by a licensed physician. I understand by submitting this form I am authorizing the minor to participate in the SCORE program.Parents Name First Last Physicians Name First Last Physicians Phone100% Coaching Guarantee: At Score, we will never cancel a lesson with a student. To insure adequate staffing we use an automatic recurred billing system. If you need to miss a practice, we will allow you to make it up if times are available. If you need to cancel your membership with Score Basketball at any time, you must provide 30 days written notice in advance of the cancellation so that we may adjust our staff accordingly.Name on Credit Card* Credit Card #* Expiration Date* CVV* Billing Zip Code* I understand that my monthly membership dues will come out automatically each month until canceled. I authorize Score Basketball to process these payments for my membership. I understand that there is a 30 day cancellation policy and that I must provide 30 days notice prior to cancellation.
