Valpo Hoops Feeder League Signup
Boys 3rd, 4th, 5th, and 6th grade/Girls 3rd, 4th, 5th, 6th, 7th & 8th
League Dates are as follows:
Oct. 20 (evaluation), Oct. 27th, Nov. 3rd, Nov. 10th, Nov. 17th, Nov. 24th, Dec. 8th, Dec. 15th (tourney)
Name of Player
*
First Name
Last Name
Choose a League
*
Boys League
Girls League
Choose a Grade
*
3rd
4th
5th
6th
7th (girls only)
8th (girls only)
Jersey Size
*
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Choose your School
*
Central
Cooks Corners
Flint Lake
Heavilin
Immanuel
Memorial
Northview
Parkview
St. Paul
TJE
Ben Franklin MS
Thomas Jefferson MS
Other
Player experience for their age - please select 1.
Beginner (limited experience)
Intermediate (plays recreationally)
Advanced (plays competitively)
Does Your Child have any Chronic Illnesses, Allergies, or Injuries that will hamper their ability to play in the league
*
yes
no
If yes, please explain here.
Back
Next
Guardian Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Emergency Contact Name
First Name
Last Name
Relationship to player
Emergency Contact Number
Please enter a valid phone number.
Insurance Carrier
*
Name of Policy Holder
First Name
Last Name
As the legal parent or guardian, in the event of illness or accident, I give consent for the Valpo Boys Hoops LLC and its Staff to secure any and all necessary emergency medical care for my child. The undersigned gives permission to Valpo Boys Hoops LLC and its owners and operators and members of the Valparaiso High School Boys & Girls Basketball Coaching staff to seek medical treatment for the participant in the event they are not able to reach a parent or guardian. I request that my child be transported to Northwest Health Porter Hospital in the event of an emergency. I hereby declare we have listed any physical/mental problems, restrictions, or conditions and/or declare the participant to be in good enough physical and mental health to participate in basketball practice and games.
*
Yes
As the legal parent or guardian, I release and hold harmless Valpo Boys Hoops LLC, its owners and operators, and its Coaching Staff, and the Valparaiso Community School Corporation from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant and/or the undersigned, while in or upon the premises or any premises under the control and supervision of Valpo Boys Hoops LLC and Valpo Hoops LLC, its owners and operators or in route to or from any of said premises.
*
Yes
Be respectful: Respect players, coaches, officials, and other spectators. Be positive: Cheer for good plays, encourage fair play, and avoid booing the other team. Be supportive: Show team support and recognize good effort. Be safe: Be alert to prevent accidents and respect the safety of children. Be responsible: Be responsible for your own actions and respect the rules of the facility. Avoid disruptive behavior: Don't argue with officials, taunt other fans, or throw items on the field. Avoid harassment: Don't use foul language or harass players, coaches, or officials. Avoid discrimination: Don't discriminate against anyone based on gender, sexuality, ability, cultural background, or religion. Be aware of the rules: Follow the rules and regulations for the event
*
I agree to the general spectator code of conduct stated above
Back
Next
If you would like to volunteer as a Coach state your name below.
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Have you coached Valpo Hoops in the past?
Yes
No
Please explain your basketball background.
Back
Next
My Products
*
prev
next
( X )
2024 Feeder League
$
110.00
Quantity
1
2
3
4
5
6
7
8
9
10
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
Submit
Should be Empty: