SJUMC 2022 Basketball Clinic Registration
 "Hosted by SJUMC Sports Ministry"


Dates: 8/6, 8/20, 9/3, 9/24 (All Saturdays)


Time: Kinder to 3rd grade group 10 AM - 11:30 AM
4th grade to 6th grade group 12 PM - 2 PM

Where: SJUMC Garden Church (6929 Franklin Blvd., Sacramento, CA 95823)
Tuition: free

Spectators are encouraged to wear masks when they are not playing.

If you have a question, please contact Corey at ckamehaiku@proton.me or the church phone 916-421-1017



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Email *
Child 1 Name *
Which date(s) can Child 1 attend? (check all he/she can attend)
Child 1 Grade (fall 2022) *
Child 1 Allergies *
If answered "Yes" Child 1 Allergies please describe
Child 2 Name
Which date(s) can Child 2 attend? (check all he/she can attend)
Child 2 Grade (fall 2022)
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Child 2 Allergies
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If answered "Yes" Child 2 Allergies please describe
Child 3 name
Which date(s) can Child 3 attend? (check all he/she can attend)
Child 3 Grade (fall 2021)
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Child 3 Allergies
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If answered "Yes" Child 3 Allergies please describe
EMERGENCY CONTACT NAME
EMERGENCY CONTACT Phone
EMERGENCY CONTACT Relationship
Please check 1 or 2 below to indicate desired action in the event of an accident or emergency.
2) I do not choose the above statement and desire the following action to be taken
Physician's Name
Physician's Phone
Medical Insurance Name (Kaiser etc.)
Child 1 Medical Record #
Child 2 Medical Record #
Child 3 Medical Record #
Would you like to volunteer/help with the basketball Clinic? *
A copy of your responses will be emailed to the address you provided.
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