ONLINE REG -YOUTH

*PLAYER NAME: *ADDRESS: *CITY: *STATE: *ZIP: *TELEPHONE: CELL PHONE: Email *Gender
Male
Female
*D.O.B.: *AGE: *HEIGHT: *GRADE ENTERING IN SEPTEMBER 2010 *PARENT/GUARDIAN(IF UNDER 18) *EMERGENCY CONTACT: *TELEPHONE: *DOCTOR: *TELEPHONE: Please choose carefully. Once the season has begun & shirts are given out, if a parent chooses to move a child to an upper or lower bracket, there will be an additional $5.00 fee to help defray the cost of the new shirt which will need to be ordered.
*PLEASE INDICATE AGE BRACKET\DIVISION:
AGES 7-9 ($75.00 fee)
GRADES 5-6 ($75.00 fee)
GRADES 7-8 ($75.00 fee)
GRADES 9-12 ($75.00 fee)
*I authorize emergency medical care at my expense & authorize release of medical information from my doctor to those providing treatment.
I agree
*I waive, release, absolve, indemnify and agree to hold harmless the B.B.A., the Board of Directors, sponsors, supervisors, staff and any volunteer connected with the program of any responsibility or financial compensation in the case of injury.
I agree
*I (parent\guardian) give approval for the above named player to participate in any & all league activities & I assume all risks & hazards.
I agree
You must click the "submit" button in order to complete your registration. PLEASE DO NOT CLICK "SUBMIT" MORE THAN ONCE When your registration is transmitted, you will automatically be redirected to the PLAYE PAYMENT page. At this time you will have the option to pay with a credit card or by pay pal by clicking on the "player fee" button. If you chose to send a check, please make payable to BBA and mail to 311 Bakerville Road, Dartmouth, Ma 02748.

FOR REGISTRATION TO BE EFFECTIVE, PAYMENT MUST BE RECEIVED PRIOR TO MAY 1, 2010.

*PLEASE NOTE PLAYERS NAME & DIVISION ON CHECK

COMMENTS:

B.B.A. BASKETBALL, INC.

@ "THE COMPLEX"

ONLINE REG -YOUTH