DeWitt Youth Basketball Registration

2025-2026 DeWitt Youth Basketball Registration
Player’s Name*

First NameLast Name
Gender*

MaleFemale
CURRENT AGE
Birth Date*

MonthDayYear
GRADE

PRE-KKRG1ST2ND3RD4TH5TH6TH
What school does your child currently attend?*
Are you a returning player

YesNo
Parent/Guardian Information
Parent #1*

First NameLast Name
Parent #2

First NameLast Name
Primary Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Cell Number*

Area CodePhone Number
Secondary Number

Area CodePhone Number
E-mail*
Date*

MonthDayYear
Date
Person Completing this form
Should be Empty: