Register for Training Sessions
  • Submit your application for upcoming training sessions.
  • An email with your information will be sent safely to Coach Carlos Ratliff.
  • Fill in the fields and press the "Submit" button below.
  • Payment method will be decided when order is confirmed
  • All information you submit will be kept strictly confidential.
Student's Name:
  
Address:
City:
State:
Zip Code:  
Gender:  
School Attending:       Grade:
Age on July 1, 2007:       Height:
Parent or Legal Guardian:  
Home Phone:
Work Phone:
Cell Phone:
Email Address:  
Confirm Email Address:  
Payment Preference:  



Application Agreement:
I agree to conform to the regulations of West Texas Basketball Academy.
Signed: Date:

Release of Liability: We as parents or guardian of the above mentioned boy/girl, hereby grant permission to participate in the West Texas Basketball Academy and acknowledge the fact that he/she is physically able to participate in session activities. We hereby release the facility, where the lessons will be taught, and its employees from all claims from injuries or illnesses which may be sustained by our son or daughter and authorize the director or his designee to select hospital facilities and/or physician of his choice and authorize treatment of the above named student on an emergency basis in the event such treatment becomes necessary while attending basketball sessions. I understand that any campus involved nor any party will be responsible for any accident while attending West Texas Basketball Academy.
Signed: Date:
How did you hear about West Texas Basketball Academy?
  
Comments:
  
 
     


 
This web site is currently under construction.

For more information, please contact:
Carlos Ratliff
(817) 689-0779


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