Core Basketball Academy Registration

Your personal information is collected for registration and emergency purposes only and will be protected in accordance with the BC Personal Information Protection Act (PIPA).

Welcome to Core Basketball Academy's Fall Session! 🏀

We are thrilled to help your young athlete develop their skills, teamwork, and confidence on the court this season. Please complete the registration details below to secure your spot.

Program Dates: Oct. 27, 2026 – Dec. 8, 2026
Location: Topham Elementary (21555 91 Ave, Langley Twp, BC V1M 3Z3)
Schedule: Tuesdays, 5:30–7:30 PM (1 Hour Session Depending On Cohort)

Questions? Reach out to Michael at CoreBasketballAcademy1@gmail.com.

Participant Details

Child's First Name

Child's Last Name

Child's Date of Birth

Age Cohort

Ages 4–6: 5:30-6:30pm (Born between 2020-2022) - FULL

Ages 7–9 GIRLS ONLY: 6:30-7:30pm (Born between 2017-2019)

Skill Level

Beginner

Intermediate

Advanced

Emergency & Medical Information

Parent/Guardian Full Name

Relationship to Child

Email Address

Confirm Email Address

Phone Number

Emergency Contact Name

Emergency Contact Phone Number

Any medical conditions or allergies?

Yes - please specify below

Child's Medical Conditions or Allergies

Additional Comments or Info

How did you hear about us?

Waiver & Consent

Liability Waiver & Refund Policy: I understand that participation in sports activities involves inherent risks of physical injury. I hereby release, waive, and discharge Core Basketball Academy, Topham Elementary, Michael Cheung, and Samantha Pyke from any and all liability, claims, or demands. I acknowledge the inherent risks associated with communicable diseases and agree to follow safety protocols. Emergency Medical Authorization is granted. All registration fees are final and non-refundable.

Photo & Media Consent: I grant permission for Core Basketball Academy to use photographs or videos of my child taken during the program for individual keepsakes such as customized photos, as well as promotional materials.

I have read and agree to the liability waiver and refund policy.

I consent to the use of photos/videos of my child for individual keepsakes (e.g., customized photos).

I consent to the use of photos/videos of my child in promotional materials (e.g., social media, website).

Accuracy Certification

I certify that all information provided above is true and accurate to the best of my knowledge.

Order Summary

Fall Basketball Session: Oct 27 – Dec 8, 2026
Total: $125.00 CAD
Secure payment processed below via Stripe.

Promo Code

Payment Method

Pay via Credit Card (Stripe)

Pay via E-Transfer

E-Transfer Instructions:
Please send your payment of $125.00 to CoreBasketballAcademy1@gmail.com.

Important: Please include the child's full name in the e-transfer memo/message field so we can match your payment to your registration. Your spot will be confirmed once payment is received.