2025 Childrens Basketball Registration

2025-2026 Children's Basketball Season

Deadline for fee and registration is November 30, 2025.
Child's Name*
Gender*

MaleFemale
Age:*
Date of Birth*

MonthDayYear
Date
Child's Grade:*
Child's School*
Does your child have any allergies or medical conditions that we need to be aware of?
Jersey Size:*
Parent/Guardian*
Home Address*
Email Address*
Cell Phone*
Parent/Guardian
Email Address
Cell Phone
In an emergency please contact:*
Relationship*
Cell Phone*
I, as a parent/guardian, grant permission for my child to participate in the above program and release Vinton Baptist Church or any other church facilities and the coach(es) from any liability for damages, or injuries which might be incurred during the operation of this program. I assure that a physician prior to participation has examined my child. In the event I cannot be reached, I give permission for my child to receive emergency meidcal care. I verify that the above is true and complete to the best of my knowledge.
Signature*

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Date*

MonthDayYear
Date
A registration fee of $55 is due at time of sign up. I will make payment via:*

Cash to Vinton Baptist ChurchCheck to Vinton Baptist Church. (Please write child's name and "Children's Basketball" in memo line.)Online payment at vintonbaptistchurch.org/give. (Select Fund: Children's Basketball Registration, then one-time gift.)Scholarship Assistance Needed.
We would love your help coaching!

I would be interested in coaching my child's team.I would be interested in being an assistant coach for my child's team.I coached a team last year.Other
Any additional comments:
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2025-2026 Children's Basketball Season