Name:                                                                                                         Date of Birth:

Age:                          Grade:                       School:

Height:                       Primary Position:                    Shirt Size:                   Sex: Male/Female

Home Street Address:                       

City:                                                                                          State:                                                      Zip:

Phone Numbers:                       

Email:                       

Waiver: I understand that I am enrolling my child in the Basketball Stars of America/Hoop Mountain PA Program and that the Basketball Stars of America, Coach Daryn Freedman, Hoop Mountain PA, Sewickley Academy, South Hills JCC or any coaches will not be liable for any injuries incurred during participation in the program. I also understand that there are no refunds! If a player is injured and can’t continue, he or she will receive a prorated credit towards another BSA or Hoop Mountain PA program.


Signature of Parent/Guardian:                                                                                                       Date:

Programs: Please check all attending

Sunday Basketball Boot Camps - _____ # of sessions
Winter AAU Basketball League - NIT NCAA NBA East NBA West WNCAA WNBA
Hoop Mountain Academies: Point Guard Academy Post Player Academy
Basketball Workouts - Elite/Jr. Elite Basketball Player Workout Early Bird Workout
Speed, Quickness & Basketball Strength Sessions - Full Season or _____ # of sessions
Mini Camps: Nov. 26 Nov. 28 Dec. 1 Dec. 22-24 Dec. 29-Jan. 2 Jan. 19 Jan. 20  Jan. 26 Feb. 13 Feb. 16

Please mail completed registration form along with a check made out to: Basketball Stars of America LLC, c/o Coach Daryn Freedman, 547 Burkes Drive, Coraopolis, PA 15108. Online Registration is available at www.basketballstarsofamerica.com