Circle the league you plan to play
5-6 year olds
7-8 year olds 9-10 year olds 11-12 year old
13-15 year olds
Mini Baller
Biddy Ball Youth league
Mid League Senior League
2010
Youth Basketball Registration Form
Participant Information
Participant’s Name:__________________________________
Skill Level:
Beginner ____ Intermediate ______ Advanced ______
Phone:_______________________________
Age:______________Date of Birth:__/__/___
Shirt Size: YS YM YL AS AM AL AXL
Adress:_________________City:_________________Zip:__________________
School:____________________________________________
If a parent or Guardian is interested in coaching please give your name and contact information.
Name:__________________Phone:_______________Shirt Size:______________
Parent/Guardian
Information
Name:_____________________________
Relationship:________________________
Address:_________________City:_________________Zip:__________________
Phone:___________________
(Work)___________________
Emergency Contact Information
Please list two individuals who
may be contacted in an emergency in the instance that parent/guardian cannot be reached.
Name:__________________________
Relationship:_____________________
Phone:__________________________Cell (if
applicable)_____________________
Name:__________________________
Relationship:_____________________
Phone:__________________________Cell (if applicable)_____________________
