In-House & Travel Program Registration

Complete the form below to register your player in our In-House or Traveling basketball programs.

Player Information

Please provide the following information about the player registering.
Select a Program*
Player's Name*
Phone Number*
Address*
City*
State*
Zip Code*
Grade*
Gender*
Height*
Shirt Size*
Traveling team participants will try on uniform
shirts at tryouts.
Short Size*
Traveling team participants will try on uniform
shorts at tryouts.

Medical Information

Please provide the following medical information for your child.
Child's Medical Facility*
Doctor's Name
Phone Number
List any medical conditions.
Please include any comments that will help us
consider where your child should be placed.

Parent or Guardian Information

Please provide the following information.
Parent/Guardian Names*
Home Phone*
Cell Phone
Email Address*
Emergency Contact*
Relationship*
Phone Number*
Parent/Guardian Agreement*
 I hereby agree to assume responsibility for any injury that may occur to my son/daughter in conjunction with this basketball program. 
 I do not agree to assume responsibility. 

Coaching Information

Please complete the following fields if you or someone else you know is interested in coaching a team.
Interested in Coaching?
If Yes, please enter the person's name as the Head
Coach Candidate or the Assistant Coach Candidate
below.
Head Coach Candidate
Assistant Coach Candidate
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