HUI LOKAHI ACADEMY BASKETBALL SKILLS CLINIC REGISTRATION FORM


Thank you for your interest in HUI LOKAHI ACADEMY'S BASKETBALL SKILLS CLINIC. Please fill out the following registration form so we can register you for our upcoming clinic sessions. Our Clinics will be held at St. Stephen's Diocesan Center on Sundays starting May 27, 2018 and ending July 22, 2018 (End dates may change due to unforeseen circumstances).  Due to our limited court space we can only accommodate 10 participants in Group A and 15 participants in Group B.  The remaining participants who have registered will then be placed on a wait list. Participants will be required to attend all clinic sessions. Payments are final with no refunds after the first week. Clinics will be led by Coach Scott LaBoy and assistants.  

For more information, call Scott LaBoy (808) 781-7957 or e-mail huilokahiacademy@gmail.com. We will confirm your participation and enrollment via email upon receipt of payment.

Clinic Fee: $135.00 per session (For those participants who have not paid required insurance and administrative fees)
                  $100.00 per session (For those participants who have paid required insurance and administrative fees)
               

CLINIC SESSIONS:

Group A: Ages 7 - 9 (1:30pm-2:30pm)  

Group B: Ages 10 and older (2:30pm-4:00pm)  


Make Check payable to: HLA Inc.

Mail Checks to: HLA Inc.
                          PO BOX 1394
                          Kailua, HI 96734


Mahalo!

HUI LOKAHI ACADEMY
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PARTICIPANT INFORMATION: PLEASE COMPLETE ALL *REQUIRED INFORMATION
PARTICIPANTS NAME *
LAST NAME, FIRST NAME
AGE/GRADE (grade current school year) *
BIRTHDATE *
mm/dd/yyyy
ADDRESS *
STREET, CITY, STATE, ZIP
EMAIL ADDRESS *
CONTACT PHONE NUMBER *
XXX-XXX-XXXX
ADDITIONAL PHONE NUMBER FOR TEXT ANNOUNCEMENTS
XXX-XXX-XXXX
EMERGENCY CONTACT INFORMATION *
Name, Relationship, Phone Number
MEDICAL INSURANCE *
SCHOOL ATTENDING *
CURRENT SCHOOL YEAR
JERSEY SIZE *
Please choose from the drop down list.
BASKETBALL EXPERIENCE *
Please choose from the drop down list
MAHALO FOR YOUR REGISTRATION. PLEASE CLICK SUMBIT TO COMPLETE YOUR REGISTRATION.
I AM REGISTERING FOR:   *
PLEASE MAIL PAYMENT TO: HLA Inc., PO BOX 1394, Kailua HI, 96734
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