Start by letting us know if you are a New Player ($250) or a Returning Player ($150 or $250 if new uniform is needed).

New Player            Returning Player 

Player Information
Player’s Name     Age  9 10 11 12 13 14 15 16 17 18
Birth date  January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995
Height             Weight 
School              Grade   5th 6th 7th 8th 9th 10th 11th 12th
Uniform Size Small Medium Large Extra Large
Address 
City/Zipcode 
Basketball playing experience 
Has player attended any basketball camps?  Yes No
If yes, which ones and when? 

Parent/Guardian Information
Mother/Guardian Name  
Father/Guardian Name    
Phone 1 / Phone 2 
E-Mail (Optional) 

I have filled out the above registration to the best of my knowledge. 
I understand that I must mail a check to complete registration. 

Please fax all player application forms to:
813-643-8274