Basketball Training, Pick-Up Games, Scottsdale Leagues

Complete online (fillable) • Grades 7–12 • Submit digitally

1) Student & Program Information +

Student Legal Name

Preferred Name

Date of Birth

Applying for Grade

Intended Start Date

Program Interest

Home Address

City / State / ZIP

2) Parent / Guardian Information +

Parent/Guardian 1 Full Name

Relationship to Student

Phone (Cell)

Parent/Guardian 2 Full Name

Relationship to Student

Phone (Cell)

3) Health, Dietary & Behavior +

Medical Conditions / Allergies (include reaction details)

Dietary Restrictions / Needs

Behavioral Concerns or Safety Plan Notes (if any)

4) Parent Goals / What You’re Looking For +

What are you looking for in your child’s school experience? Any questions?

5) Consents & Signatures +

I authorize emergency medical treatment if I cannot be reached. I give permission for supervised field trips / off-campus activities. I allow use of student photo/video for school communications (as applicable). I certify the information provided is true and complete.

Parent/Guardian Printed Name

Date

Digital Signature (type full legal name)

By submitting, you acknowledge Swysh Den Academy may use this information for admissions review and student support planning. For document uploads, use the upload link provided by Admissions.

Business Hours