Wilson County Civic League
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Site Name

Wilson County Civic League

Phone

(615) 449-0719

Site Name

Wilson County Civic League

Phone

(615) 449-0719

Tagline

Improving Social Conditions in the Community Since 1984.

Summer Basketball Application

Summer Basketball Application

You can fill out the form below to apply for the Summer Basketball Camp OR you can print the PDF linked here and email or drop it off:

Printable PDF Application / Permission Slip - PDF form will open in a new window

Summer Basketball Camp
Parent / Guardian Last Name *
Parent / Guardian First Name
Street Address *
City
State *
Zip Code
Day Phone *
Evening Phone
Cell Phone
Email Address
Student Last Name
Student First Name
Student Relationship to Applicant
Student Grade Level
Student Sex
Male
Female
School Attending
Homeroom Teacher's Name
Annual Household Income
Medications (Please describe / list)
Food Allergies (Please describe / list)
PERMISSIONS: I give permission to travel on WCCL transportation
Yes
No
PERMISSIONS: I give permission to Participate in WCCL Programs
Yes
No
PERMISSIONS: For All Travel:
I will supply transportation
My child will use any WCCL transportation
The WCCL reserves the right to use information on participants for research, data collection, advertising, newspapers, and other pictures.
Digital Signature - Type your name here to certify this application
Please answer the security question below to verify that you are a real person.
What COLORS are in the United States of America Flag?
Answer


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