Basketball Clinic

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Youth Day Clinic

Day Basketball Clinic With The Halifax Rainmen

January 2nd, 2015 (11am to 2pm)
at Scotia Bank Centre 1800 Argyle St. Halifax, NS B3J 2V9
Ages: 7-15

Name:_____________________________________ Phone:_______________

Mailing Address:____________________________ Email:_______________

Age: ____ MSI#:______________ T-shirt size:_____

Parent/Guardians:

This form must be signed for your child to attend the Rainmen Day Clinic.
In case of medical emergency, I understand that every attempt will be made to contact the parent/guardian of the camper. Yes_____ No_____
I give permission for the Halifax Rainmen to obtain medical treatment for my child. Yes____ No_____
I assume the risk of injury and will not hold the Halifax Rainmen Clinic and/or their staff or volunteers liable for any injuries. Yes_____ No_____
I hereby give permission to the Halifax Rainemen to film the Clinics and use the footage obtained.
Parent/guardian Signature: __________________________________

Please Click Here to download the above form and Email or Fax it to:

Rainmen Office
Email: info@rainmenbasketball.ca
Fax: 1.866.424.4267
Phone: 902. 444. RAIN (7246)



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