SUMMER LEAGUE Registration Form

Summer Basketball League
Player Name

First NameLast Name
Jersey Size
Age
Birthdate

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School (High School or College)
(type most recent school if graduated)
CHOOSE YOUR LEAGUE🏀
Guardian / Parent Name

First NameLast Name
Parent Cell Phone
Format: (000) 000-0000.
Parent Email:
example@example.com
Upload your basketball pic!

Cancelof
Player Instagram
Ex: @playerinstagram
Player Twitter (X)
Ex: @playertwitter
Emergency Contact & Health Insurance Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Format: (000) 000-0000.
Do you have any allergies, chronic illness, or medical conditions that would limit high level activity?
Please describe (if unknown type NA)
Release of Liability

Although the safety of all sport activities is the primary concern, Basketballl activities at Delavan Moselle Community Center and Tapestry Charter School facility may cause injuries and/or death. I expressly assume the risk of injury, death, and/or illness arising from any cause, and agree to waive the right to pursue any claim against The Unit Promise, Delavan Moselle Community Center & Tapestry Charter School.
I have read and agree to the above conditions
Confirmation E-mail
example@example.com

Product Name

Registration & Jersey Fee

$60.00 Quantity

Enter coupon

Subtotal

Tax

Total

Credit Card

Apple Pay

Google Pay

Cash App Pay

ACH Bank Transfer

Summer Basketball League