Winter Basketball 9-12 Registration Form

Please complete the PLAYER'S Name, Email Address and Phone Number. If you want to register more than one person, please select the option "ADD another person/item to this registration" on the next page (after you click the SUBMIT button).

Cost $ 100.00

First Name:

Last Name:

E-Mail:

Player's Contact Phone

Player is a

Grade

Gender

Shirt Size

Short Size

Team playing with/Team Capt.

Parent/Guardian Information: (Note: one parent per each home game is required to help at scorekeepers table - Head Coach will assign this duty)

Primary Parent Contact Name

Primary Parent's Cell Phone

Primary Parent's E-Mail

Parent/Guardian Signature (approval for participation as explained on the info page)

Date

(Only click the Submit Button Once)