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Summer 2023 REGISTRATION SYNERGY BASKETBALL
Age
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Grade
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Players Full Name
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SPECIALIZED PROGRAMS
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FREE TRIAL
TEAM SYNERGY: Option 1 (Millworks- Westford, MA)
TEAM SYNERGY: Option 2 (YMCA- Plaistow, NH)
TEAM SYNERGY: Option 3- UNLIMITED
SKILLS & DEVELOPMENT: (Millworks- Westford, MA)
MIX IT UP (D-UP, Offensive Attack, Game Situation & GUT CHECK)
3pc. COMBO (Specialized Shooting, Skills & Development, XTREME)
BOOT CAMP (indoor & outdoor)
PRIVATE LESSONS - 1 Lesson
PRIVATE LESSONS - 5 pack
PRIVATE LESSONS - 10 Pack
PRIVATE LESSONS - 2hr. Lesson
PRIVATE LESSONS - 2hr (5- pack)
PRIVATE LESSONS - 2hr (10- pack)
Additional Programs: Ex. SKILLS & DEVELOPMENT
School
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Contact Information
1.) Parent / Guardian's Full Name
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Email
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Phone number
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2.) Parent / Guardian's Full Name
Email
Phone number
Uniform Size
(Youth & Adult sizes): S, M, L, XL, XXL
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Preferred Jersey Number
Permission and Liability Waiver
As the parent or legal guardian of the above-named player, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb, or well-being of your child. I agree to hold Synergy Basketball, LLC harmless for any injury that may result from activities in the Synergy Basketball Program. I, the parent/ guardian assumes all risks and hazards incidental to the conduct of the Synergy Basketball Program activities. I also give my permission for the Synergy Basketball Program to publish, copyright, or use all films and photographs in which my son/ daughter is included for any exhibitions, displays, web pages and publications without reservation or compensation.
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