Basketball Clinic
  • Applicant
  • Participants
  • Medical Release
  • Certification
Would you like to volunteer? *
Experience has shown that parents who provide a positive attitude help ensure that the league is a positive experience for all involved. The goal of this recreation league is for our participating children to have fun! With that in mind, we ask that you read and agree to the Belmar Recreation Code of Conduct before completing registration. This Code of Conduct applies to all applicants along with any other guardians/representatives of each participant.
  • I/We hereby pledge to provide positive support, care and encouragement for my child participating in the upcoming recreation season.
  • I/We will encourage good sportsmanship by demonstrating positive support for all players, coaches and officials at all games.
  • I/We will place the emotional well-being of my child first; ahead of my desire to win.
  • I/We will refrain from any negative remarks to opposing team players, coaches and fans.
  • I/We will work to ensure my child participates in a safe and healthy environment.
  • I/We will support coaches and officials working with my child in order to encourage a positive and enjoyable experience for all.
Code of Conduct
First Name *
Agreement *
We realize that you may be interested in getting more involved to provide a better experience for your son or daughter. If you are interested in getting involved, please complete this section and we will contact you to provide more information. Please understand that if interested, the borough may conduct a background check and you may be required to participate in a training course.
Applicant Details (Parent)
Email *
Last Name *
Address 2
Phone # *
Specify which activity(ies) you wish to volunteer for, and in what capacity e.g. Coach, Referee, Umpire, etc.
Address *
I am aged eighteen (18) years or older
City *
State *
Some activities are only available to residents of Belmar/Lake Como, and St. Rose students. Specify the residency of all participants in this application.
Participant Details
Participant(s) Residency *
Relationship to Participant(s) *
Emergency Contacts
Last Name
Agreement *
Phone #
First Name *
Phone # *
Last Name *
Relationship to Participant(s)
This information is vital to ensure complete protection should your child need medical treatment:

The Borough of Belmar has my permission to administer any and all medical attention necessary to my child in the event of an accident, injury, sickness, etc., should I be unable to be contacted. I give my permission and authorization to take my child to the nearest hospital/urgent medical care facility should it be necessary. I give my permission and authorization to the hospital and/or medical staff to provide treatment which a physician deems necessary for the well being of my child. I further certify that I have medical insurance for my child and to assume any costs or expenses resulting from treatment administered

I agree to assume all responsibility for any injury or illness resulting from any Belmar Recreation activity and hereby hold harmless and waive all rights and action I may have against the Borough of Belmar, Belmar Recreation, and all other persons involved in the activity/organization or any facility involved in Belmar Recreation programs.

I certify that, to the best of my knowledge, the child’s current physical condition is satisfactory for participation in this year’s programs and activities and that the child is free of any health problems which would endanger them.

I will inform the Director of Belmar Recreation at (732) 681-3700 ext.211 should the child’s condition change at any time.

I agree to abide by all rules, regulations, and policies set forth by the Belmar Recreation Department.

I agree that my child must obey the instructors, coaches and referees designated to direct this activity.

I agree to all the above set forth by the Belmar Recreation Department and Borough of Belmar at any and all times while participating in any Belmar Recreation activity.

Provide details for at least one (1) person to contact in the event of an emergency.
First Name
Type Full Name :
Sign With Hand
Agreement *
Amount Due
The Belmar Recreation Department has a no refund policy. If your child is removed from a Belmar Recreation program or activity due to behavior issues, the Belmar Recreation Department will not grant a refund. If a parent/guardian decides to remove their child or children for any reason at all from any Belmar Recreation program or activity, the Belmar Recreation Department will not grant a refund.
By signing below, the applicant certifies that all of the information provided in this application is true and accurate.
No Refund Policy
Signature *