Redeem a Basketball Stars of America Program Voucher: *Note: If you purchased multiple vouchers, you must redeem them individually! Participant Information Participant Name * Grade Home Street Address * City * State * - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code * Cell Phone Number 1 * Cell Phone Number 2 Home Phone Number Email 1 * Email 2 Program and Voucher Programs Choice Voucher Code Note: (If Groupon Voucher, it is the 8 Digits under Bar Code. If Amazon Voucher, it is the first 4 Letters or Numbers of Voucher Code) Agreement By Clicking Submit, I am agreeing to the following: I understand that I am enrolling my child in the Basketball Stars of America Program or affiliated program and that the Basketball Stars of America and any affiliates, Coach Daryn Freedman, or any coaches or facilities used will not be liable for any injuries incurred during participation in the program. I also understand that there are NO REFUNDS! If a player is injured and can’t continue, he or she will receive a prorated credit towards another BSA or affiliated program. I also understand that my child’s picture or team picture may be used in future BSA advertising material. Parent/Guardian Name * Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20242025 Leave this field blank
