Legacy Reign Basketball – Developmental Workouts Registration

Legacy Reign Basketball – Developmental Workouts Registration

Directly after the form is completed, you will be redirected to the contribution link.
Parent / Guardian Information
Parent / Guardian Full Name

First NameMiddle NameLast Name
Relationship to Athlete
Email Address
example@example.com
Mobile Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
City
State / Province
ZIP / Postal Code
Preferred Method of Communication
Athlete Information
Athlete Full Name

First NameMiddle NameLast Name
Preferred Name / Nickname
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Age
Grade
School
Height
Jersey Size
Basketball Experience
Years played basketball
Previously played organized basketball?
Where did you play organized basketball?
Current strengths

Other
Areas you would like to improve
Medical Information
Does the athlete have any medical conditions?
If yes, please explain the medical conditions
Does the athlete have any allergies?
If yes, please explain the allergies
Emergency contact name

First NameMiddle NameLast Name
Emergency contact phone number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency contact relationship
Electronic Signature
Parent / Guardian Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: