BOUNCE OUT THE STIGMA 2018 Saturday Afternoon Basketball Clinic
in conjunction with our Sponsor the Julia Anne Kirsch Foundation

Special Needs Basketball Clinic 5 Weeks on Saturday Afternoons, Starts January 6, 2018* |  Glen Rock, New Jersey

Basketball Camp Registration Bounce Out the Stigma

Special Needs Basketball NJ, Glen Rock

Click on Flyer to Enlarge or  Download a PDF File to Print →

Cost of this Clinic is $50.00 – Which Covers 5 Weeks – Each Child Gets a Basketball & Certificate of Accomplishment
* Clinic Schedule: Saturdays 1:30-3:00  Jan 6, 13, 27 – Feb 10, 24 (no clinic Jan. 20, Feb. 3 & 17)

 SPACE IS LIMITED – This Clinic Will Fill Up Fast, Please Register Now, Using This Form



Registration Form March 10 and 11 , 2018 Basketball Clinic St. Petersburg, FL
All Fields Are Required.


Parent or Guardian's Name * :

Your Relationship to Camper *:

Campers Name ( first, last name only if different from yours } * :

Campers Nick Name:

Campers Age * on January 1, 2018 :

Campers Grade as of January, 2018 * :

T-Shirt Size * :

Returning Camper*: YESNO


Your Email Address *:

Tel. # We Can Reach You* : (format 201-555-1212)

Home Address* :

City* :

State* :

Zip * :

Please Feel Free to Share Any Additional Information About Your Child, that You Feel Would be Helpful.

Add Me To Your Newsletter: YesNo

*Please Tell Us How You Heard About Us


If you do not receive a call or forms in the mail in 2 weeks, Please call us at 855.997.3900.

To Avoid Spam, Please Insert the Code You See

In Conjunction With and Our Underwriting SponsorJulia Anne Kirsch Foundation


Learn More About Julia Anne Kirsch Foundation 


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