Pottstown P.R.I.D.E. Basketball Registration 2026

Player's Name

First NameLast Name

School

Division

BoysGirls

Grade

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Jersey Size

Significant Allergies or Past Illnesses

Mother/Guardian's Name

First NameLast Name

Mother/Guardian's Cell Phone Number

Area CodePhone Number

Mother/Guardian's Home Phone Number

Area CodePhone Number

Mother/Guardian's Email

example@example.com

Father/Guardian's Name

First NameLast Name

Father/Guardian's Cell Phone Number

Area CodePhone Number

Father/Guardian's Home Phone Number

Area CodePhone Number

Father/Guardian's Email

example@example.com

THIS STATEMENT MUST BE SIGNED BY PARENT/GUARDIAN FOR MINOR PLAYER; COACH FOR HIMSELF OR HERSELF AND ADMINSITRATOR FOR HIMSELF.

I the parent/guardian of the registrant; a minor, agree that the registrant and I will abide by the rules of P.R.I.D.E., it’s affiliated organizations and sponsors.

Recognizing the possibility of physical injury associated with basketball and in consideration for P.R.I.D.E. accepting the registrant for its basketball program, I hereby release, discharge and/or otherwise indemnify and hold harmless P.R.I.D.E. It’s affiliated organizations and sponsors, their employees and associated personnel, including the owners of basketball courts and facilities used for the program against any claim by or on behalf of the registrant as a result of the registrant’s participation in the programs and/or being transported to or from the same, which transportation I hereby authorize.

Your Name (please sign below)

First NameLast Name

Signature - Please sign with mouse or finger.

Date*

Date

Registration Options - All payments will be made through Venmo, CashApp, Check, or Cash

BOYS - Grade 3/4 - $90BOYS - Grade 5/6 - $90BOYS - Grade 7/8 - $90GIRLS - Grades 3-5 - $90