Breakthrough Basketball

Breakthrough BAsketball Camps

In response to many requests we are developing a summer program that will incorporate skills training, games and basketball IQ (classroom concepts that will cover basketball strategies, physical fitness, nutrition, and life skills). This program will be 5 weeks long and be comprised of 5 skills training sessions and 5 games for a total of 10 one hour sessions.
Our objective is to develop hard working, resilient, confident and knowledgeable individuals that want to maximize their potential and make a positive impact in the community.
Modesto Slam-N-Jam has always had the philosophy that players develop through playing. It is through playing that they learn the love of the game. Winning every game is not the ultimate goal, but improving through experiences is the true win. It is our hope that this combination program of training and games will help promote this philosophy.

Registration: May 19, 2018
Grades/Times:
3rd-4th at 9:00 AM
5th-6th at 10:00AM
7th-8th at 11:00AM
Program Dates: June 3, 8, 11, 15, 18, 22, 25, 27, 29 & July 1st
Times: TBA (1 hour sessions that can range MWF from 3– 8 PM & Sun 1-6 PM)
Location: Big Valley High School (1020 Pelandale Ave.)
Price: $125
Discount Price: $110 for SNJ members who already have a SNJ reversible jersey
Register Online via the below form
Or mail application to: Modesto SNJ Summer Breakthrough Basketball
3430 Tully Road #20
Modesto, CA 95350
(Paper Application Under Camps/Clinics Tab)

Sign up early as space is limited

Breakthrough Basketball

Player Information

* Indicates required field

Name *

First

Last

Players Birthday (ex. 01/23/2005) *

Gender *

Height (ft) (in) *

Mailing Address *

Line 1

Line 2

City

State

Zip Code

Country

School *

Grade Level *

Player Experience *

Never Played League Baskeball Played 1 Year Played Multiple Years Played Multiple Years + Travel Ball

Uniform

T-Shirt *

Parent/Guardian of Player INformation

Name *

First

Last

Name of Person Making Payment (Even if same name as above) *

To ensure there is an accurate payment record - We ask that if you or someone else is paying the fees for Summer Camp that it be indicated in the above box. This allows for Modesto Slam-n-Jam to keep accurate records for the season. Thank you for your understanding and cooperation.

Primary Phone *

Secondary Phone *

Email *

Medical Information

Insurance Company *

Name of Policy Holder *

Policy Number *

Present Health of Player *

Medications (Enter N/A if none) *

Allergies and/or Drug Sensitivities (Enter N/A if none) *

Past Health /Injuries (Enter N/A if none) *

Consent for Medical Treatment for a minor:

As a parent or legal guardian of the above player. I hereby authorize the directors of MSNJ to use their best judgement in any emergency requiring medical attention. I hereby waive and release MSNJ from all liabilities. I will be responsible for any medical or other charges in connection for my son or daughter.

Participation Consent:

I, the parent/guardian of the above player agree that I will promote good sportsmanship by modeling positive behaviors in the MSNJ event facility. This is in regards to officials, players, coaches, fans, and MSNJ staff. If I have a concern I will take it to the MSNJ Director.

Photo/Video/Audio Consent & Waiver:

MSNJ requests the rights to use all photos, videos, and/or audio clips of players and adults engaged in the participation of a MSNJ event. These may be used for a promotional brochure, our website, local newspaper and other purposes. I hereby forfeit any rights to claims for payments/royalties.

By signing below (provide a check in the YES box), I confirm that I understand and agree to the above requests and conditions. I confirm by checking the box below that I am at least 18 years old and the parent/guardian responsible for the player above.

I/We agree with the above. *

Yes

Complete registration includes: both the REGISTRATION form and payment. please submit both!

Submit

Payment must be submitted along with above REGISTRATION form.
please submit both for complete registration

To ensure that we credit your payment correctly, please indicate the name of the player in the "notes to the seller" box before submitting payment.

YOUR PAYMENT RECEIPT WILL BE EMAILED AND IS PROOF OF REGISTRATION & PAYMENT
tHERE IS A $2 oNLINE pAYMENT CONVENIENCE FEE - IT IS INCLUDED IN THE TOTAL PRICE.