GENESIS SPORTS ACADEMY INTEREST FORM

Athlete's First Name (required)

Athlete's Last Name

Parent's First Name (required)

Parent's Last Name (required)

Parent's Email Address (required)

Parent's Primary Phone Number (required)

Athlete's 2025/26 Grade (required)
5th-8th5th Grade6th Grade7th Grade8th Grade

Current City of Residence (required)

What club basketball team does your child play for?

Current Basketball Level
Beginner (new to organized basketball)Developing (some experience, still building fundamentals)Intermediate (has played on a team, understands game basics)Advanced / Competitive (club or high-level team experience)

How did you hear about us? (required)

Is your child looking to repeat a grade this year? (required)
YesNo

Documentation — Once you apply, you will be contacted for report cards, birth certificate, and immunization records. Check if you agree to provide these.
I agree to provide required documentation

Additional Comments