WordPress Basketball League Registration Form

First Name

Last Name

Age

Gender

MaleFemaleOther

Contact Number

Email*

Address

Address Line 1

Address Line 2

City

State or Region

Country

Zip

Basketball skill level

Introductory - I just started playingBasic - I have experience and need to build fundamental skillsAdvanced - I have played on travel, middle school or high school teamsPerformance - I have participated in city/regional competitions

Are you interested in volunteering when your team is not playing?

Unfortunately, I don't have enough time at the momentMatch RefereeScoreboard Operator

Do you have health insurance?

YesNo

Do you have any allergies, chronic illnesses or medical conditions that would limit high-level activity?

YesNo

If yes, please describe

Release of Liability

Although the safety of all sports activities is our primary concern, indoor sports activities at Sports Center Name facilities can result in injury and/or death. I expressly assume the risk of injury, death and/or illness from any cause and agree to waive any and all claims against Sports Center Name and its officials.