Youth Basketball League Registration Form

Wyoming Valley Youth Basketball League 2021- Registration Form

wvyb570@gmail.com
Athlete Information
Player Name*
First NameLast Name
GRADE
SEASON 1 RETURNING PLAYER?*
YesNo
TEAM # DID YOU PLAY FOR? blanks TEAM COLOR? blank
SHIRT SIZE
Basketball skill level*

1 2 3 4 5
1 is Begginer, 5 is Advanced
Guardian / Parents Names*
First NameLast Name
Address*
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
PHONE 1*
Area CodePhone Number
PHONE 2
Area CodePhone Number
E-mail*
Interested in Volunteering ?
HEAD COACHASST. COACHSCOREBOARD WHILE CHILD IS PLAYINGFRONT DESK ATTENDENT (PRE-GAME ONLY)
WOULD YOU LIKE TO BE A GAME SPONSOR
$25 PERSONAL DONATION$50 COMPANY ONLINE & ON SCHEDULES $50$100 COMPANY ONLINE, SCHEDULES, CHECK IN TABLE$200 COMPANY ONLINE, SCHEDULES, CHECK IN TABLE & SCORETABLE$300 ALL ABOVE AND ON MAIN BASKETSNO
I would like to play on the same team with following players. League organizers will form teams base on this buddy list and your skill level.
Second Contact & Health Insurance Information
Second Contact's Name*
First NameLast Name
Relationship*
Phone Number*
Area CodePhone Number
PAYMENT OPTIONS
VENMO @wvyb570I'll pay with cash by deadlineREGISTRATION $20 + $50 League Fee (NEW PLAYERS)Returning Player $40Ask for Payment PlanApply for Scholarship
Does you have any allergies, chronic illness, or medical conditions that would limit high level activtiy?*
YesNo
Please describe*
Confirmation E-mail*
EACH PLAYER REGISTERED WILL RECEIVE A SAFETY WAIVER AFTER COMPLETED REGISTRATION AND FULL PAYMENT. WE WILL NEVER TURN AWAY A PLAYER DUE TO FINANCIAL ISSUES; BUT NO PLAYERS WILL BE ABLE TO PLAY IN FIRST GAME UNLESS REGISTERED FOR INSURANCE REASONS. PLEASE MAKE A PAYMENT ARRANGEMENT WITH THE DIRECTOR OR APPLY FOR A PLAYER SCHOLARSHIP...
After completing this form, please click Submit Form. You will receive a confirmation email. If you do not receive the email within a few minutes, please check your spam; otherwise, please contact us at WVYB570@GMAIL.COM.
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