Date:

Parent First Name(s):
Last Name:

Address:

City:

State:

Zip Code:

Phone Numer 1:
Phone Numer 2:

Email Address:

Athlete's Name:

Athlete's Birthdate:

Athlete's Age:

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All ages as of September 1

	Youth Basketball (ages 8 to 10)	Team Fee.....................$40.00
	Elementary Boys Basketball (ages 12 & under)	Team Fee.....................$75.00
	Elementary Girls Basketball (ages 12 & under)	Team Fee.....................$75.00
	Junior High Boys Basketball (ages 14 & under)	Team Fee.....................$100.00
	Junior High Girls Basketball (ages 14 & under)	Team Fee.....................$100.00
	Junior Varsity Boys Basketball (ages 16 & under)	Team Fee.....................$125.00
	Junior Varsity Girls Basketball (ages 16 & under)	Team Fee.....................$125.00
	Varsity Boys Basketball (ages 18 & under)	Team Fee.....................$150.00
	Varsity Girls Basketball (ages 18 & under)	Team Fee.....................$150.00
	Varsity/JV Girls Soccer (ages 18 & under)	Team Fee.....................$75.00