St. James College- Individual and Small Group Session

1
Sign Up FORM
2
Individual or Small Group Session

Private Individual: $85/hr

Small Group: (2) $45/hr (3) $35/hr (4+) $30/hr (Athletes)

Team of 8-12 Players: $140/hr

*EMAIL Coach Justin at PureJoyBasketball@gmail.com for desired time slots!

Location

St. James College
3
Select an Option* This field is required.
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 costAUD
Private Individual
$85.00AUDEdit
Back
0
0
1
2
3
4
5
6
Quantity
Small Group of 2
$90.00AUDEdit
Back
0
0
1
2
3
4
5
6
Quantity
Small Group of 3
$105.00AUDEdit
Back
0
0
1
2
3
4
5
Quantity
Small Group of 4
$120.00AUDEdit
Back
0
0
1
2
3
4
5
Quantity
Team
$140.00AUDEdit
Back
0
0
1
2
3
4
5
Quantity
Pure Joy T-Shirt
$25.00AUDEdit
Back
Total cost $0.00AUD
4
Special RequestIf you have any questions, please let us know!
5
Player Name* This field is required.
First Name
Last Name
6
Age* This field is required.
7
Additional Player name(If applicable)
First Name
Last Name
8
Age
9
Parent Name* This field is required.
First Name
Last Name
10
Email* This field is required.
example@example.com
11
Phone Number* This field is required.
Area Code
Phone Number
12
Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by the Pure Joy Basketball during the selected clinic. In exchange for the acceptance of said child’s candidacy by the Pure Joy's Basketball Clinic, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Pure Joy Basketball and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected clinic sessions.

In case of injury to said child, I hereby waive all claims against Pure Joy Basketball including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including basketball. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.
13
I have read and agree to the above conditions* This field is required.
Yes
No
14
Confirmation

BY AGREEING ABOVE AND SUBMITTING THIS FORM, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT IS EQUIVALENT TO AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Should be Empty: