SKILLS AND DEVELOPMENT PROGRAM
Grades 3 & 4 – Any skill level encouraged to participate
Girls practice Monday & Wednesdays
Boys practice Tuesdays & Thursdays
3:30 – 5:00 p.m. at Memorial Hall
Christian environment with fun & fellowship
Teaching basketball skills and good character!
Transportation from school is available—indicate necessity on
Registration form
Director: Joel Johnson, KHS Varsity Baseball & former Varsity Girls Basketball Coach
First Church – United Methodist Basketball Academy
To Register or find out more information:
--print and complete the registration form below
--Mail to Church office or stop by at 313 East Montgomery or
All participants and parents encouraged to attend orientation meeting Sunday, January 13 at 5:00 p.m., basement of First United Methodist Church, 313 East Montgomery.
BASKETBALL
ACADEMY
3rd/4th Grade – Winter 2013
REGISTRATION FORM Need transportation? Yes / No
Participant Information:
Name: ______________________________________Grade_____ Gender: Boy / Girl
Address: ____________________________ City: ___________________ Zip: ____________
Phone: __________________ Email: ___________________________________(print clearly)
T-shirt Size: ______________ Last Name for Shirt Back _______________________________
Adult: S – XXL Youth: S -- XL
Emergency Contact Information:
Name: ___________________________________________ Relationship:_______________________
Phone: ________________ Please indicate any allergies or medical problems staff should be aware of: ___________________________________________________________________________________
Release of Liability and Assumption of Risk
The use of the premises, facilities, equipment, and services at Knoxville First United Methodist Church naturally involves risk of injury to you or your guest, whether you or someone else cause it. As such, you understand and voluntarily accept this risk and agree that Knoxville First United Methodist Church will not be liable for any injury, including, without limitation, personal, bodily, or mental injury, economic loss or any damage to you, your spouse, guests, unborn child, or relatives resulting from the negligence of Knoxville First United Methodist Church or anyone on Knoxville First United Methodist Church’s behalf or anyone using the facilities.
Picture Release
I hereby give my consent to let my child be photographed for use by the Knoxville First United Methodist Church to be used in newspaper or other media. No names except First United Methodist Church will be used.
___________________ __________________________________________
Date Signature of Parent or Guardian
COST: $25.00 Mail or deliver to church office. Please come to orientation meeting on
Sunday, January 13 at 5:00 p.m., basement of First United Methodist Church.
Checks payable to First United Methodist Church.
