Upper Perk Youth Basketball

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Travel Team Registration Form

2024-2025 REGISTRATION FORM
UPPER PERKIOMEN YOUTH BASKETBALL LEAGUE (UPYBL)
***TRAVEL TEAM***

* Player's Name:

Male

Female

* Age:

* Grade:

* DOB:

* School Attending?:

Jersey Shirt Size:

Short size:

* Previous Basketball Experience (e.g. Travel, AAU, CYO, etc.):

Yes

* Would you like to be put on a Saturday League Team? (This is included with your Travel Team Fees):

Yes, I'd like to be put on a team for In House League

No, I do not want to participate in Saturday play

Additional Information (Medical, Transportation needs, etc):

* Street Address:

* City:

* Zip code:

Home Phone::

Mother/Guardian Name:

Mother/Guardian Cell #:

Mother/Guardian Email:

Father/Guardian Name:

Father/Guardian Cell #:

Father/Guardian Email:

* Emergency Contact Phone:

* Emergency Contact Name:

* Emergency Contact Relationship to Player (other than parent):

* Doctor Name:

* Doctor Phone Number:

Registration Fee: $300

+ $100 Uniform Fee*

*If you are able to reuse your uniform from last year, you do NOT have to pay the uniform fee for this year

Additional Siblings Travel cost will be $250 per child (+$100 Uniform Fee if you need a new uniform)

UPYB is currently accepting payment via Paypal or Venmo (offline option)

* Do you need to purchase a new uniform?:

Yes (+$100)

No, I will reuse mine from last year

I know that participating in basketball may result in serious injuries and protective equipment does not prevent all injuries to players, and do hereby waive, release, absolve, indemnity and agree to hold harmless the Upper Perkiomen Youth Basketball League and it's directors, officers, coaches, participants, and persons transporting my child to and from activities for any claim arising out of any injury to my child whether the result of negligence or any other cause, except to the extent and in the amount covered by insurance. In the event of an emergency, I give my permission to league and team officials to secure emergency treatment from a licensed physician, or take my child to the nearest hospital for emergency treatment.

* Initials of Parent/Guardian:

* Date::

Please write in space below if interested in coaching, team manager, scorekeeping, team sponsor, etc...:

* indicates required fields

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Travel Team Registration Form