Parent/Guardian Name(s)*
Phone Number(s)*
Email Address*
Number of Kids Signing Up:* (1) $250 (Total)(2) $400 (Total)(3) $500 (Total)(4) $600 (Total)
Full Name*
Date of Birth*
Jersey Size*: Youth SmallYouth MediumYouth LargeAdult SmallAdult MediumAdult Large
Jersey 1st Number*:
Jersey 2nd Number*:
Friend / Teammate Request 1st (optional):
Friend / Teammate Request 2nd (optional):
Friend / Teammate Request 3rd (optional):
Skill Level: BeginnerIntermediateAdvanced
Full Name
Date of Birth
Uniform Size Youth SmallYouth MediumYouth LargeAdult SmallAdult MediumAdult Large
Friend / Teammate Request (optional)
Support our youth basketball league and receive a tax receipt.
Team Jersey Sponsorship – $360 (includes tax receipt) NoYes
League Sponsorship – $1000 NoYes
Sponsor / Business Name (optional)
Contact Person (optional)
Sponsor Phone (optional)
Sponsor Email (optional)
Would you be interested in coaching? NoYes
Would you be interested in being a referee? NoYes
You will be asked to submit payment on the next page.
PLEASE COMPLETE PAYMENT ON NEXT PAGE THAT YOU WILL BE REDIRECTED TO.
REGISTRATION WILL ONLY BE COMPLETED WHEN PAYMENT IS SUBMITTED.