Basketball Registration 2026-2027

Basketball Registration

Deadline: December 5th 2027
Child Information
Name

First NameLast Name
Birthday

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Age
Age Group
Size
Parent Information
Parent Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Email
example@example.com
Medical Concerns
There is a $50 online registration fee that must be paid by August 12th. If paid after the deadline there will be a $10 late fee. Once you have registered your child you will recieve an email with practice information.

Age Groups: Age Control Date is September 1st 2024.

Registration Fee $50.00

Football & Cheer Registration

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

It is understood that the Jefferson County Recreation Department will do everything we can to prevent injury. However, should an injury occur, meither the Jefferson County Recreation Department nor the individual leaders shall be responsible. I likewise release from responsibility and person transporting my child to or from any activity. I also give permission to the person in charge of the activities to take my child to the doctor or hospital in case of an injury. Refunds are only issued if the Recreation Department has to cancel the season. I understand the release and give full approval to that effect.
I understand the release above.

First NameLast Name
Should be Empty:

Basketball Registration