CLEVELAND LANCER BASKETBALL
REGISTRATION REQUEST
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Student Athlete
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student Athlete Age
Grade of Student Athlete
Students Grade Point Average
*
Please Select
3.6 -4.0 B+ to A Average
3.00-3.5 B Average
2.00 -2.9 C Average
Is there any health conditions or medications we should know about
How did you hear about us?
Signature
Submit
Should be Empty: