nyImpact Youth Basketball League, Founded in 1993, Impact Youth Basketball League is run on a year-round basis, winter and summer. FREE month long basketball clinics, nyImpact Youth Basketball League, Founded in 1993, Impact Youth Basketball League is run on a year-round basis, winter and summer. FREE month long basketball clinics, nyImpact Youth Basketball League, Founded in 1993, Impact Youth Basketball League is run on a year-round basis, winter and summer. FREE month long basketball clinics, nyImpact Youth Basketball League, Founded in 1993, Impact Youth Basketball League is run on a year-round basis, winter and summer. FREE month long basketball clinics, nyImpact Youth Basketball League, Founded in 1993, Impact Youth Basketball League is run on a year-round basis, winter and summer. FREE month long basketball clinics, nyImpact Youth Basketball League, Founded in 1993, Impact Youth Basketball League is run on a year-round basis, winter and summer. FREE month long basketball clinics, nyImpact Youth Basketball League, Founded in 1993, Impact Youth Basketball League is run on a year-round basis, winter and summer. FREE month long basketball clinics, 



I __________________________,  hereby give my son / daughter _____________________ permission to play basketball.  While my child is registered in Impact, I will adhere to the rules and regulations of the league and its organizers.  I also give league officials  the right to dismiss my child from the league  if his/her (or my) behavior or attitudes are deemed detrimental to the best interest of the league.  I understand that my deposit/registration fee(s) is  NOT refundable under any circumstances.  

In case of illness or accident, the individual shall have immediate care.  I release and discharge the  Mpact Youth Inc. its staff, coaches and organizers of any liability for injury to my child resulting from or in any manner connected with my child’s participation in the program.  The League is also not responsible for articles of clothing, basketballs, Jewelry, sneakers or other personal belongings lost, misplaced, damaged or stolen.

In signing this -PRCOCCRRRF - document, I’m certifying that my child is in good health, with  no chronic illness or abnormal tendencies.

I hereby wave my rights to bring any action, legal or otherwise against the Impact Youth Program, its staff or its organizers.  I also understand that there are absolutely NO refunds under any condition.  In addition, I authorize the staff of the Impact Youth Tournament to act for me according to their best judgement in any emergency requiring medical attention for my child.  I have no knowledge of any physical impairment that would affect the above person's participation in playing basketball.  I further understand that Impact Youth Tournament retains the right to use for publicity and advertising purposes, photographs and video taken at the game of my child (or me) with no compensation due.  I hereby give my child permission to play.
Child's First Name
2nd Child Info:
Parent's Registration.....Code Of Conduct, Consent, Release, Renewal/Receipt Form - (PRCOCCRRRF)
Phone
DOB
Medical I.D.
Winter or Summ/Yr.
Health Plan
Parents/Guardian
* Sign-Up Today!!
Please click on price below
then fill out Information 
and submit
(Bottom of page)
Is Available!
FINANCING*
Parent Consent Form
Must  put down $125 and
pay balance by Saturday
January 4th 2025.
Must be done in person in
the gym on Saturday Nov.
9th.   Open to  the first 25
 people looking to finance.
PLEASE NOTE:..Only paid
registrants  will be  able to attend the basketball "skill" training camp in November 
and December!
(* No Interest Charged)
Last Name:
Parent / Guardian Signature______________________________  Price Paid:__________________Date:_____________
(Electronically sign)