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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
[email protected]
.
Submit Form
