Basketball Tryouts Registration Form
For questions or additional info, contact Damien McClain at dmcclai@yahoo.com or 704-562-7934. If you are registering more than one child, please fill out a separate form. Thank you.
Participant's Full Name
*
First Name
Last Name
Parent/Guardian's Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Participant's Date of Birth
*
-
Month
-
Day
Year
Date
Student's Grade
*
6th
7th
8th
9th
Registering more than one child?
*
Yes
No
Emergency Contact Information
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Medical Information
Do you have questions or concerns?
Parent/Guardian Signature
*
Submit
Should be Empty: