Online Registration

- 2017 Training

After completing the registration form below, mail payment to Texas Express Basketball, P.O. Box 126559, Fort Worth TX 76126 along with a completed and signed medical waiver form. If you would like to make your payment on line, use the link provided under the submenu. The medical waiver may be mailed or brought to the first day of camp. No child will be able to participate without completion the required documents and payment.
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- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- 2017 Training Locations
- Select Day(s) of Training Class REQUIRED Please fill out this field.
- Select Class Time REQUIRED Please fill out this field.
- Gender REQUIRED Male Female Please fill out this field.
- Grade and Age REQUIRED
  List participant's 2016-2017 grade and current age
  Please fill out this field. Please enter valid data.
- Parents/Guardians Names REQUIRED
  List both parents first and last names
  Please fill out this field. Please enter valid data.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Permission to join our mailing list? Yes
- Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- List the name and phone number of a person we can contact in case of an emergency.
- Emergency Contact Information REQUIRED Please fill out this field. Please enter valid data.
- 2017 Texas Express Training
  Assumption of Risk- Liability and Medical Release
  
  I hereby authorize the staff of the Texas Express Basketball Club to act for me as the parent/legal guardian, according to their best judgment, in any emergency requiring medical attention during the 2017 Texas Express Training Program, and hereby waive and release the directors, trainers, coaches, and/or anyone associated with the Texas Express Basketball Club along with any facility and its associaties from any liability for any injuries or illnesses incurred while participating in the 2017 Texas Express Training program.
  
  I have no knowledge of any medical problem or physical impairment that would negatively impact/hinder my child’s participation in such training sessions. If my child has a medical issue that could impair his/her performance such as asthma, a previous injury,…, I, knowingly choose to allow my son/daughter to participate, and have released this information, in writing, to the Texas Express Basketball Club.
  
  It is, furthermore, understood that The Texas Express Basketball Club and any facility and its associates will not provide medical insurance covering injuries of any nature incurred during a Texas Express Training session.
  
  The undersigned hereby releases The Texas Express Basketball Club, any facility used, its successors, assigns, officers, agents, and employees, from any and all claims, demands, and causes of action whatsoever in any way growing out of or resulting from participation in The 2017 Texas Express Training program.
- Assumption of Risk/Liability and Medical Release Please check box that you have read and agree with the liability and medical release above
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