Clone of High Intensity Basketball Training Sign Up

1
Image Field
2
Which Session are you Attending? (Only 20 slots Per Session)
Please Select
Saturday 7am
Saturday 8am
3
Gender
Male
Female
4
Full Name* This field is required.
First Name
Last Name
5
Best Contact Email* This field is required.
example@example.com
6
Best Contact Phone (Call/Text)* This field is required.
Please enter a valid phone number.
7
Age Group* This field is required.
Please Select
Please Select
10u-14u
15u-18u
Adult
8
T-Shirt Size (Monthly Signup)* This field is required.
Please Select
Please Select
YS
YM
YL
AS
AM
AL
AXL
9
How did you hear about Plyo University?* This field is required.
Social Media
Friend/Family
Flyer
Website
10
🔹 Acknowledgment of Risk* This field is required.
I, the undersigned parent/guardian, acknowledge that participation in basketball activities, practices, training sessions, games, and related events with H-Town Supreme Fall Ball League (Lead Through Athletics) at 4 Quarters Gym involves risks, including but not limited to: falls, collisions, physical contact, sprains, broken bones, and other injuries. I understand these risks are inherent to the sport and cannot be eliminated.
I do not agree
11
🔹 Waiver & Release* This field is required.
In consideration of my child’s participation, I hereby release, waive, and discharge H-Town Supreme Fall Ball League, Lead Through Athletics, 4 Quarters Gym, coaches, staff, volunteers, and affiliates from any and all liability, claims, or demands for personal injury, property damage, or wrongful death arising from participation in league activities, whether caused by negligence or otherwise.
I do not agree
12
🔹 Medical Treatment Authorization* This field is required.
I authorize Lead Through Athletics and 4 Quarters Gym staff/volunteers to seek emergency medical treatment for my child in the event of injury or illness. I agree to be responsible for any associated costs.
I do not authorize
13
🔹 Insurance Responsibility
I understand that Lead Through Athletics and 4 Quarters Gym do not provide medical insurance for participants and that it is my responsibility to carry appropriate coverage for my child.
14
Parent/Guardian Signature
15
Any additional comments or needs we should know about?* This field is required.
16
Date Signed
Date
Month
Day
Year
17
Are you or do you have any company interested in donating to Lead Through Athletics? (We are a 501c3 nonprofit organization.)* This field is required.
Yes
No
18
My Products
prevnext( X )
My Bag
0
My Bag
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
ORDER SUMMARY
Total costUSD
Free 1st Session
Come Try Us Out
Edit
Back
4 Pack
Monthly Membership
Edit
Back
Pop Up Session
Pop Up Session
Edit
Back
Pay Cash Upon Arrival

Edit
Back
Enter Coupon
Total cost
19
Payment Methods
Fastlane Checkout
Choose from one of the PayPal options to make your payment.
Contact Info
Payment Info
Should be Empty: