Basketball Registration

Player Contact Info:
First Name*
Last Name*
Middle Initial
Gender* Male
Female
Grade*
Birthday mm/dd/yyyy*
Address 1*
Address 2
City*
State*
Zip Code*
Home Phone*
Email
If Attend Church Which One
Player Information Notes (if any)
Player Experience & Sizing Info:
How many years has your child played organized basketball?*
To help us better coach your child... AT PLAY, your child is best described as (1-10)*
1 being the least assertive and 10 the most assertive please pick the number from above.

Sizing (Available During Evaluations)
Please pick what you think for now.
Jersey*
Basketball Shorts*
If applicable, Check night your child CANNOT practice. Monday
Thursday
Friday
Parent / Guardian Information
Father / Guardian
Work Phone
Cell Phone
I would like to assist this league by being a: Coach
Referee
Concessions
Scorekeeping
 
Mother / GUARDIAN
Work Phone
Cell Phone
I would like to help this league by being a: Coach
Referee
Concessions
Scorekeeping
 
Name of Emergency Contact*
Daytime Phone*
Evening Phone*