Cowan Heights Youth Basketball League

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Registration Form

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Player's Name
Age
Gender
Date of Birth
Street Address
City
Postal Code
Home Phone
School and Grade
MCP # (Mandatory)
Is the player returning from a previous session?
Does the applicant have prior basketball experience? If so, please explain.
Does the applicant have any known medical condition which may affect his/her participation in the league? If so, please explain.
In case of an emergency, please provide the name(s) and phone number(s) of appropriate contact(s)
  

 

Cowan Heights Youth Basketball League

Registration Form

 

 Applicant Information (Mandatory)

Name:   

Age:

Address: 

Gender:    ¨  M           ¨  F

City:                                       Postal Code:

DOB: 

Phone:

Grade:

MCP: (Mandatory)

School

 

Is the registrant returning from a previous session?     ______

 

Does the registrant have prior basketball experience? ______

If so, please elaborate: ___________________________________________________________

______________________________________________________________________________

 

 

Does your son/daughter have any medical condition(s) that may affect his/her participation in this league?  ________ 

If yes, please describe:

___________________________________________________________________________________

___________________________________________________________________________________

 

 

In case of emergency, contact: ___________________________TEL:_________________(Mandatory)

 

Parental Information

Father’s Name:

Phone: (H)

 

           (W)

Mother’s Name:

Phone: (H)

 

           (W)

 

e-mail Address:

 

Are you interested in co-coaching your son’s/daughters team? _____,

 

Are you interested in being a divisional convener? _______________

 

Are you interested in volunteering any time with CHYBL?  ____________

 

If you answered yes to the any of the above questions please provide your name.______________

 

This information will be distributed to coaches and conveners.

 

Refund Policy:  No refunds will be given after the second scheduled game unless for medical reasons and approved by the league executive.  No refunds will be given after the 5th scheduled game.

 

 

Date:  _____________   Amount: _________    Cheque: ____________   Cash: __________