VBCA Registration Name(required) Email(required) Phone(required) School/ Organization(required) School Address(required) Coaching Level(required) Select an option Varsity Middle School / Junior High Elementary Program(required) Select one option Boys Basketball Girls Basketball Both Coaching Position(required) Select one option Head Coach Assistant Coach Youth Coach VBCA Membership Select your 2026–27 VBCA membership option. Membership provides access to VBCA member benefits, resources, voting privileges, player award eligibility and other association programs. Membership Selection(required) Head Coach Membership — $50 Jr. High / Elementary Membership — $25 I already have a current VBCA membership — $0 I am registering for the clinic only — $0 2026 Fall Coaches Clinic November 1, 2026 You may register for the clinic individually, as a coaching staff, or select “Not attending” if you are purchasing membership only. Clinic Registration(required) Individual Coach — $50 Boys OR Girls Staff (3+) — $100 Boys AND Girls All Staff — $175 Youth Coach — $25 Not attending the clinic — $0 T-Shirt Size Select one option Small Medium Large XL 2XL Please select your preferred shirt size for the 2026 Coaches Clinic. Dietary Restrictions or Food Allergies(required) Please list any dietary restrictions or food allergies we should be aware of. If you do not have any, enter None. Staff Registration Information Complete this section only if you selected a staff clinic registration above. Individual registrants may skip this section. Additional Coach 1 Name Email Coaching Position Select one option Head Coach Assistant Coach Youth Coach T-Shirt Size Select one option Small Medium Large XL 2XL Please select your preferred shirt size for the 2026 Coaches Clinic. Dietary Restrictions or Food Allergies Please list any dietary restrictions or food allergies we should be aware of. If you do not have any, enter None. Additional Coach 2 Name Email Coaching Position Select one option Head Coach Assistant Coach Youth Coach T-Shirt Size Select one option Small Medium Large XL 2XL Please select your preferred shirt size for the 2026 Coaches Clinic. Dietary Restrictions or Food Allergies Please list any dietary restrictions or food allergies we should be aware of. If you do not have any, enter None. Additional Coach 3 Name Email Coaching Position Select one option Head Coach Assistant Coach Youth Coach T-Shirt Size Select one option Small Medium Large XL 2XL Please select your preferred shirt size for the 2026 Coaches Clinic. Dietary Restrictions or Food Allergies Please list any dietary restrictions or food allergies we should be aware of. If you do not have any, enter None. Additional Coach 4 Name Email Coaching Position Select one option Head Coach Assistant Coach Youth Coach T-Shirt Size Select one option Small Medium Large XL 2XL Please select your preferred shirt size for the 2026 Coaches Clinic. Dietary Restrictions or Food Allergies Please list any dietary restrictions or food allergies we should be aware of. If you do not have any, enter None. Additional Coach 5 Name Email Coaching Position Select one option Head Coach Assistant Coach Youth Coach T-Shirt Size Select one option Small Medium Large XL 2XL Please select your preferred shirt size for the 2026 Coaches Clinic. Dietary Restrictions or Food Allergies Please list any dietary restrictions or food allergies we should be aware of. If you do not have any, enter None. Payment Method How would you like to pay?(required) Credit/Debit Card — Pay Online Pay by Check / Request an Invoice School / Organization Billing Information Complete this section if your school, athletic department or organization will be paying by check or requires an invoice. School / Organization Billing Name Billing Contact Name Billing Contact Email Billing Address Purchase Order Number (if applicable) Confirmation I confirm that the information provided above is accurate and understand that registrations and memberships paid by check are not considered paid until VBCA receives payment. CONTINUE TO PAYMENT / SUBMIT REGISTRATION Δ