Emergency phone or Cell #_________________

Email Address_________________________________________________

 Age _________

Please check box □  Monday Men’s Basketball Monday Night Cost $190

Please check box □ Monday  Men’s Basketball both nights Monday and Thursday cost $300

Late fee of $20 will be applied after October 12th, 2015. Refunds after Augustr 1st will be minus $35 for administrative fees. No refunds will be given back after September 1st, 2015, doctors note is required. I, the adult applicant, _________________________ Date _________________hereby give approval for the applicant’s participation in and any Hopewell Basketball program; I will not hold the organization and sponsors, their employees and associated personal, including owner of fields and facilities utilized for the programs against any claim by or on behalf of the registrant as a result of the registrant ‘s participating in the program and/or being transported to or from the same, which transportation. I give permission to the Hopewell Basketball Association to use photographs of myself and /or my child for historical archives, educational, and promotional purposes. These materials may be used for immediate of future use. I understand that there is no remuneration and that the pictures will not be used for commercial purpose.

 To register, submit completed registration form with payment and sent it to Hopewell Basketball PO Box 613 Pennington NJ 08534 Mail to : Hopewell Basketball Association PO BOX 613 Pennington NJ 08534
To Pay by credit card click here. Follow directions on next page.