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JR NBA – Registration
SECTION 1 — PARENT / GUARDIAN INFORMATION
Parent / Guardian Full Name
*
Parent / Guardian Email Address
*
Parent / Guardian Phone Number
*
SECTION 2 — PLAYER INFORMATION
Player Last Name
*
Player First Name
*
Player Date of Birth
*
Player Current Grade
*
Age Division
*
*Divsions may be merged
Age Division
A
BRONZE: 4 - 6 year olds
B
SILVER: 7 - 9 year olds
C
GOLD: 10 -12 year olds
Player School
*
Player Gender
*
Shirt Size
*
SECTION 3 — PROGRAM SELECTION
Which season are you registering for?
*
How did you hear about our program?
*
How did you hear about our program?
A
Advertisement
B
Friend
C
Website
SECTION 4 — VOLUNTEER COACH
Are you interested in coaching this season?
*
Are you interested in coaching this season?
A
No
B
Yes
SECTION 5 — WAIVERS
Liability Waiver
*
Liability Waiver
I acknowledge and accept the risks associated with participation in CYAA Up-State Allstars basketball activities.
Photo / Video Release
*
Photo / Video Release
I grant permission for photos and videos of my child to be used for team and promotional purposes.
Refund Policy Acknowledgment
*
Refund Policy Acknowledgment
I understand that registration fees are non-refundable once the season begins.
Complete Registration & Payment
SUBMIT REGISTRATION
I have completed payment using the option above. If payment is not completed, your registration is not processed and your spot is not held.
*
I have completed payment using the option above. If payment is not completed, your registration is not processed and your spot is not held.
Yes
Questions or issues? Contact us at
CrosbyYouthAthletics@gmail.com.
Submit Form
