Stroudsburg Girls Basketball - Clinic Sign Ups

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Clinic Registration Form

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Student Name: *

Grade in School: *

Parent Name: *

E-mail address: *

Phone Number: *

Elementary School: *

Youth Shirt Size *

Beginner Session

Intermediate Session

Participant Consent: I hereby release Stroudsburg boys and girls basketball booster club, any volunteers, and any affiliated parties from any injuries that incur. I agree to be responsible for any medical or other charges for these activities. *

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Your form message has been successfully sent.

You have entered the following data:

Clinic Registration Form

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Error while sending the form. Please try again later.

Student Name: *

Grade in School: *

Parent Name: *

E-mail address: *

Phone Number: *

Elementary School: *

Participant Consent: I hereby release Stroudsburg boys and girls basketball booster club, any volunteers, and any affiliated parties from any injuries that incur. I agree to be responsible for any medical or other charges for these activities. *

Captcha (spam protection code) *

*

I herby agree that my data entered in the contact form will be stored electronically, and will be processed and used for the purpose of establishing contact. I am aware that I can revoke my consent at any time.

Note: Fields marked with * are required

Vacations, friends, parties, birthdays – this is where you'll find my latest photos and videos to look at and download. I look forward to reading your comments in the guestbook!

04.18.2011 – Party in the Engine Shed
The party in the old engine shed was awesome! Here are the photos for you, at last.

03.29.2011 – Pat's 75th Birthday
Grandma Pat recently invited everyone to her big birthday party. It was the first time in a long time that almost the entire family came together.

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