Heyworth Storm Travel Basketball

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Heyworth Storm Basketball Registration Form 2018 - 2019 Season

Player Information

* Gender:

* First Name:

* Last Name:

* Street:

* City:

* State:

* Zip Code:

* Primary Cell Phone For Coach To Text To:

Secondary Cell Phone:

* Birthdate:

Email:

* Shirt Size:

YXL

AXL

* Grade:

PARENT/GUARDIAN #1

* First Name:

* Last Name:

EMail:

Home Phone:

Work Phone:

Cell Phone:

PARENT/GUARDIAN #2

First Name:

Last Name:

Email:

Home Phone:

Work Phone:

Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

* Emergency Contact:

* Phone:

Relationship to Player:

Insurance Carrier:

Policy #:

In signing my child up for Heyworth Storm Basketball, I understand the following: 4th, 5th and 6th grade teams will play a travel schedule including tournaments. Teams also participate in clinics to be conducted by the associated Heyworth High School basketball coaches and athletes. The clinics are to further develop and teach fundamental basketball skills and situations. Fees paid for Storm Basketball cover insurance for home games, referees, equipment, a shooting/warm-up shirt and uniform. The shooting or warm-up shirt will be kept by the player at the end of the season the uniform must be returned in the same condition.

****Heyworth Storm Travel Basketball relies on volunteers. Parents or guardians of each player agree to work at home games and / or home tournaments during set-up, gate admissions, concessions and / or clean-up. If you can't work at your assigned date(s) it is your responsibility to find a replacement. You may be required to pay additional fees if your responsibilities are not met****

I/we agree with the above *

* Date:

* Electronic Signature:

If you are interested in coaching, please fill out the coaching form.

* indicates required fields

IMPORTANT: Online Payment with credit cards is not active for this form

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Heyworth Storm Basketball Registration Form 2018 - 2019 Season