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SPRING 2024 REGISTRATION SYNERGY BASKETBALL
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FREE TRIAL (for players who have never attended our program before)
2hr. session: Skills & Development
Date of Birth
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Gender
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Male
Female
Skill Level
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Beginner
Experienced
Advanced
Interested in SHOWCASE travel events
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YES
NO
Age
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Grade
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Players Full Name
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TEAM SYNERGY Package
Option: 1 - Plaistow, NH - $1150
Option: 2 - Haverhill, MA - $1150
Option: 3 - Westford, MA - $1150
Option: 4 - COMPLETE PLAYER - Unlimited Access! - $1500
SKILLS & DEVELOPMENT
Option 1: Tuesdays - Hunking Haverhill, Ma - $350
Option 2: Thursdays - Bradford Elementary Haverhill, Ma - $350
MIX IT UP
Option 1: Mondays - YMCA - Plaistow, NH - $425
Option 2: Mondays - Mill Works - Westford, MA - $425
SPECIALIZED SHOOTING
Option 1: Tuesdays - Hunking - Haverhill, Ma $175
Option 2: Thursdays - Bradford Elementary - Haverhill, Ma $175
Option 3: Fridays - Mill Works - Westford, Ma $140
3pc. COMBO
Option 1: Mondays - YMCA - Plaistow, NH - $425
Option 2: Mondays - Mill Works - Westford, MA - $425
TEAM TRIPLE THREAT (FREE to TEAM players ONLY)
Fridays - Mill Works - Westford, Ma - $300
Spring Break Vacation Clinic (MA & NH)
Monday, April 15th, 8-3pm - $100
Monday, April 22nd, 8-3pm - $100
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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Home Address
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2.) Parent / Guardian's Full Name
Email
Phone number
Uniform Size
Uniform Size
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Already have a uniform
Youth Small
Youth Medium
Youth Large
Youth XL
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2XL
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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