CHESTER BENGALS APPLICATION TO PLAY BASKETBALL 2026-2027

CHESTERFIELD BASKETBALL LEAGUE APPLICATION TO PLAY BASKETBALL
Lace up! It's game time! Registration is now open! Whether you're new to the game or a seasoned player, we focus on developing skills, promoting sportsmanship, and having a blast.

Basketball Fees: $50 Uniforms/$130 Registration *Uniforms will remain the same as last season*

We welcome ages 6-18 as of December 31st.

Age Brackets:
Rookies- 6-7 years old, 8 with no experience
Tigers- 8 years old and under (Recommend first year players, age 7 or 8 play in this League for one year. 6-year-old players ineligible for this Division.)
Cubs - 9 Years and under. (7 year olds are ineligible for this Division)
Bears – 10 Years
Minors - 11 Years
Nets – 12 Years
Intermediates - 13 Years
Juniors - 15 Years
Seniors - 18 Years and under. (Must not turn 19 before the end of postseason games)
PLAYER NAME:
DATE OF BIRTH:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
ADDRESS:
CITY AND ZIP CODE :
GUARDIAN NAME

First NameLast Name
GUARDIAN PHONE NUMBER:
Format: (000) 000-0000.
ELEMENTARY SCHOOL BOUNDARY:
SCHOOL ATTENDED:
DID YOU PLAY WITH CBL THE PREVIOUS SEASON?
IF YES, WHAT ASSOCIATION?:
IS THE PLAYER ON A MIDDLE SCHOOL TEAM IN ANY CAPACITY?
IF YES, HOW?
I/We, the parents or legal guardians for the above candidate for a position on a Chesterfield Basketball League team, hereby give My/Our approval to his/her participation in any and all league activities
I/We assume all risks and hazards incidental to such participation including transportation to and from the activities and I/We do hereby waive, release, absolve, indemnify and agree to hold harmless the Chesterfield Basketball League, Inc., the organizers, sponsors, supervisors, participants and person transporting My/Our son or daughter, except to the extent and in the amount covered by accident or liability insurance.
I/We agree to return all uniforms and other equipment issued to My/Our son or daughter when required in as good condition as when received except for normal wear and tear.
I/We will furnish a certified birth certificate or other proof of birth of the above named candidate at this or initial sign in
I/We understand that My/Our son or daughter is an ineligible player if he/she is named on any roster of any official school basketball team, whether public, private or parochial, during the current school year.
I/We understand and acknowledge that we are held accountable to follow the Chesterfield County Parks & Recreation Code of Conduct that applies to all associations, players and spectators.
IS THIS APPLICANT COVERED BY HEALTH INSURANCE?
Name of insurance company:
GUARDIAN NAME

First NameLast Name
GUARDIAN NUMBER
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Signature:
FREE AGENT NOT REQUIRING RELEASE
This section will be completed on paper, if required.
WAIVER REQUEST
This section will be completed on paper, if required.

CHESTER ATHLETIC ASSOCIATION
PLAYER NAME
CURRENT SCHOOL
AGE
DOB

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
ELEMENTARY SCHOOL DISTRICT
EXPERIENCE
GRADE
HOME PHONE
Format: (000) 000-0000.
PARENT NAME

First NameLast Name
Email
example@example.com
CELL
Format: (000) 000-0000.
PARENT NAME

First NameLast Name
Email
example@example.com
CELL
Format: (000) 000-0000.
STREET ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
CITY

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
ZIP

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
SHIRT/JERSEY SIZE
SHORTS/PANTS SIZE
JERSEY NUMBER 1ST
2ND
3RD
JERSEY NUMBER FROM PREVIOUS YEAR AND TEAM
PARENTS and/or LEGAL GUARDIANS AGREE TO THE FOLLOWING:
I/WE GIVE MY/OUR APPROVAL FOR MY/OUR CHILD TO PARTICIPATE IN ANY AND ALL LEAGUE ACTIVITIES.
I/WE ASSUME ALL RISKS AND HAZARDS INCIDENTAL TO SUCH PARTICIPATION INCLUDING TRANSPORTATION TO AND FROM THE ACTIVITIES AND I/WE DO HEREBY WAIVE, RELEASE, ABSOLVE, INDEMNIFY AND AGREE TO HOLD HARMLESS CHESTER ATHLETIC ASSOCIATION, THE ORGANIZERS, SPONSORS, SUPERVISORS, PARTICIPANTS AND PERSONS TRANSPORTING MY/OUR SON OR DAUGHTER.
I HAVE READ THE CODE OF CONDUCT AND UNDERSTAND SAID DOCUMENT.
I/WE AGREE TO RETURN ALL UNIFORMS AND OTHER EQUIPMENT ISSUED TO MY/OUR SON OR DAUGHTER IN AS GOOD A CONDITION AS WHEN WE RECEIVED IT EXCEPT FOR NORMAL WEAR AND TEAR. IF I/WE FAIL TO TURN IN ALL EQUIPMENT AND/OR UNIFORMS ISSUED, I/WE WILL HAVE TO PAY THE REPLACEMENT COST FOR THE ITEM OR BE SUBJECT TO CRIMINAL AND/OR CIVIL PROSECUTION.
I/WE WILL FURNISH A BIRTH CERTIFICATE OR OTHER PROOF OF BIRTH OF THE ABOVE NAMED ATHLETE.
I/WE WILL PARTICIPATE IN THE ASSOCIATIONS FUNDRAISING PROJECTS AND SEE THAT ALL MONEY AND UNSOLD MERCHANDISE IS RETURNED TO THE DESIGNATED INDIVIDUALS WHEN DUE.
I/WE AGREE TO PAY THE REGISTRATION FEE AND PURCHASE ANY UNIFORM THAT MAY BE REQUIRED TO PARTICIPATE. I/WE UNDERSTAND THAT FAILURE TO PAY MAY RESULT IN THE SUSPENSION OF ATHLETIC ACTIVITY FOR MY CHILD FROM THEIR TEAM UNTIL THE BALANCE IS PAID. ALL RETURNED CHECKS WILL BE ASSESSED A $35 FEE.
SIGNATURE(S) SIGNIFIES UNDERSTANDING OF THE AGREEMENT TO ALL DUES, FEES, AND DUTIES ASSOCIATED WITH/FOR CHESTER ATHLETIC ASSOCIATION.
SIGNED
DATE

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
SIGNED
DATE

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
I WOULD LIKE TO ASSIST THE TEAM

Chesterfield County Parks and Recreation Code of Conduct
The Chesterfield County Parks and Recreation Advisory Commission has adopted the following code of conduct as a result of its concerns for good sportsmanship in cosponsored youth activities. Youth sports can be used as an opportunity for young people to learn how to engage in healthy competition while maintaining respect for their opponents. All parties to athletic competitions should adhere to the highest standards of positive support for the contestants. By participating in Chesterfield County Youth Sport Programs, all parties must abide by the Code of Conduct. Violations may result in the loss of privileges at county facilities.
I (and my guests) will be a positive role model for my children and encourage sportsmanship by showing respect and courtesy, and by demonstrating positive support for all players, coaches, officials and spectators at every game, practice or sporting event.
I (and my guests) will not engage in any kind of unsportsmanlike conduct with any official, coach, player or parent, such as booing and taunting, refusing to shake hands or using profane language or gestures.
I will respect the officials and their authority. I will refrain from questioning, discussing or confronting coaches during the game, and will take time to speak with the officials or coaches at an agreed upon time and place.
I will remember that children participate to have fun and that the game is for the youth, not the adults.
I will demand a sports environment for my child that is free from drugs and alcohol and will refrain from their use at all youth sports events.
I realize that the purpose of my attendance is to observe a contest and support recreation activities, not a license to verbally assault others or be generally obnoxious.
I will respect the athletic facility in which I am visiting and will not damage or deface park or school property.
I have read and understand the code of conduct and consent to abide by all listed terms.
Player's Name:
Parent's Signature:
Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
A REAL ID OR BIRTH CERTIFICATE IS REQUIRED.

FOR NEW PLAYERS ONLY
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PLEASE NOTE: WHEN USING SQUARE, PLEASE INCLUDE PLAYER'S NAME
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Uniform

$50.00 Quantity

Registration

$130.00 Quantity

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CHESTERFIELD BASKETBALL LEAGUE APPLICATION TO PLAY BASKETBALL

FREE AGENT NOT REQUIRING RELEASE

WAIVER REQUEST

CHESTER ATHLETIC ASSOCIATION

PARENTS and/or LEGAL GUARDIANS AGREE TO THE FOLLOWING:

SIGNATURE(S) SIGNIFIES UNDERSTANDING OF THE AGREEMENT TO ALL DUES, FEES, AND DUTIES ASSOCIATED WITH/FOR CHESTER ATHLETIC ASSOCIATION.

Chesterfield County Parks and Recreation Code of Conduct

See below for payment methods:

My Products

Credit Card