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EAST FAIRMONT
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EAST FAIRMONT FALL BASKETBALL LEAGUE
TEAM INFORMATION
*
School:
*
Division:
High School Varsity Boys
High School Varsity Girls
JV Boys
JV Girls
Middle School Boys (6-8)
Middle School Girls (6-8)
*
First name:
*
Last name:
*
EMail:
*
Home Phone:
*
Work Phone:
*
Cell Phone:
*
Requests:
WAIVER INFORMATION
I/we agree with the above
*
Signature:
Date:
* indicates required fields
Varsity/JV Boys($375)
Varsity/JV Girls($375)
Middle School Boys($325)
Middle School Girls($325)
Blue Star Fee($16)
*
Multiple Team Fee (per Team)($325)
