Basketball

2026-2027 PROGRAMS WILL START IN MID DECEMBER AND END IN LATE FEBRUARY

Kindergarten – program will meet one day a week starting mid December (day and time tba which will be determined by the volunteer coaches and gym availability). Focus is on basketball fundamentals through drills, and games in a fun filled environment. No registration fee.

1st & 2nd Grades – games on Saturdays and one mid-week evening practice starting mid December (day and time tba which will be determined by the volunteer coaches and gym availability.) Focus is on skill improvement/development and basketball concepts through drills and games. No registration fee.

3rd through 6th Grades – focus is on skill improvement/development and basketball concepts through drills one day a week and scrimmages on Saturdays. No registration fee.

Please complete the form below to register.

Registration deadline: Monday, November 20, 2026.

Register for Cornwall Basketball

Child's Name *

Please indicate the program your child will be attending. *

Kindergarten Basketball

1st & 2nd Grade Basketball

3rd through 6th Grade Basketball

Date of Birth *

Age *

Shirt size *

Youth Small

Youth Medium

Youth Large

Participating Adult Name *

Participating Adult Email Address *

Participating Adult Address (Street & Town) *

Participating Adult Phone Number *

Cornwall Park and Recreation Activity Form

*Please fill out one for each child.*

Allergies or disabilities that supervisor should be aware of

Parent/Guardian Name *

Parent/Guardian Email Address *

Address *

Best Contact Phone Number *

2nd Parent/Guardian Name

Address

Best Contact Phone Number

Email Address

In case of an emergency and you cannot be reached, please provide another person for emergency contact:

Emergency Contact Name *

Relationship *

Emergency Contact Phone number *

PHOTO RELEASE I give permission to have my child’s picture appear on the Cornwall Park and Recreation website and Facebook page while engaged in Park and Recreation activities. *

Yes

Signature *

RELEASE AND EMERGENCY MEDICAL AUTHORIZATION

The undersigned, for themselves and/or their children as hereinafter named, hereby releases and discharges the Town of Cornwall, its officers, commissioners, commissions, employees, and agents from any and all liability for any loss or damage to property of or bodily injury or death to the undersigned arising from or related to the undersigned’s participation in the town-sponsored activity hereinafter specified; and
The undersigned does hereby further knowingly, intentionally, freely and expressly:

assume the risk for any loss, damage, bodily injury or death arising from, related to, or occurring during the undersigned’s participation in the town-sponsored activity hereinafter specified; and
releases the Town of Cornwall and its officers, commissioners, commissions, employees and agents from any and all liability for any such loss, damage, bodily injury or death to the undersigned; and
waives any claim or cause of action which the undersigned may have against said Town or its officers, commissioners, commissions, employees and agents for any such loss, damage, bodily injury or death.

If the undersigned cannot be reached, the undersigned does hereby give permission to the physician selected by the Recreation Department of the Town of Cornwall or program supervisor to hospitalize, secure proper medical treatment for, and/or to order injection, anesthesia, or surgery for myself and/or my child as participants in the town-sponsored activity hereinafter set forth.

Parent/Guardian Signature *

Date *

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