OSPR Adult Basketball League Registration - 2024

* Required Fields

Fee: $5.00Internet conveniences fee

*Register as

Team

*Team Name

Old Team Name (if changed)

Team Colors

*Has this team played in a league previously?

Yes
No

Most recent league (City/District)

Most recent division

Captain Information

*Captain Name

Street Address

City

State

Zip Code

*Captain Email

*Mobile Phone

Participant 1

*1 Name

Street Address

City

State

Zip Code

*Participant 1 Email

*Mobile Phone

Gender

Male
Female

*Date of Birth

Participant 2

*2 Name

Street Address

City

State

Zip Code

*Participant 2 Email

*Mobile Phone

Gender

Male
Female

*Date of Birth

Participant 3

*3 Name

Street Address

City

State

Zip Code

*Participant 3 Email

Mobile Phone

Gender

Male
Female

*Date of Birth

Participant 4

Don't type in this field

*4 Name

Street Address

City

State

Zip Code

*Participant 4 Email

Mobile Phone

Gender

Male
Female

*Date of Birth

Participant 5

*5 Name

Street Address

City

State

Zip Code

*Participant 5 Email

*Mobile Phone

Gender

Male
Female

*Date of Birth

Participant 6

6 Name

Street Address

City

State

Zip Code

Participant 6 Email

Mobile Phone

Gender

Male
Female

Date of Birth

Participant 7

7 Name

Street Address

City

State

Zip Code

Participant 7 Email

Mobile Phone

Gender

Male
Female

Date of Birth

Participant 8

8 Name

Street Address

City

State

Zip Code

Participant 8 Email

Mobile Phone

Gender

Male
Female

Date of Birth

Participant 9

9 Name

Street Address

City

State

Zip Code

Participant 9 Email

Mobile Phone

Gender

Male
Female

Date of Birth

Participant 10

10 Name

Street Address

City

State

Zip Code

Participant 10 Email

Mobile Phone

Gender

Male
Female

Date of Birth

Participant 11

11 Name

Street Address

City

State

Zip Code

Participant 11 Email

Mobile Phone

Gender

Male
Female

Date of Birth

Participant 12

12 Name

Street Address

City

State

Zip Code

Participant 12 Email

Mobile Phone

Gender

Male
Female

Date of Birth

Participant 13

13 Name

Street Address

City

State

Zip Code

Participant 13 Email

Mobile Phone

Gender

Male
Female

Date of Birth

Participant 14

14 Name

Street Address

City

State

Zip Code

Participant 14 Email

Mobile Phone

Gender

Male
Female

Date of Birth

Participant 15

15 Name

Street Address

City

State

Zip Code

Participant 15 Email

Mobile Phone

Gender

Male
Female

Date of Birth

Participant 16

16 Name

Street Address

City

State

Zip Code

Participant 16 Email

Mobile Phone

Gender

Male
Female

Date of Birth

Participant 17

17 Name

Street Address

City

State

Zip Code

Participant 17 Email

Mobile Phone

Gender

Male
Female

Date of Birth

Participant 18

18 Name

Street Address

City

State

Zip Code

Participant 18 Email

Mobile Phone

Gender

Male
Female

Date of Birth

Participant 19

19 Name

Street Address

City

State

Zip Code

Participant 19 Email

Mobile Phone

Gender

Male
Female

Date of Birth

Participant 20

20 Name

Street Address

City

State

Zip Code

Participant 20 Email

Mobile Phone

Gender

Male
Female

Date of Birth

Waiver

Waiver Statement: The undersigned states that he/she understands that the City of Ocean Springs Parks and Recreation are not and shall not be responsible for or liable for any illness, or injury to person or damage to property resulting from the program in which the undersigned is enrolling or being enrolled or from his/her participating in said program, and the participant and the undersigned, if the participant is a minor or under other legal disability, hereby forever releases and holds harmless the said City of Ocean Springs Parks and Recreation, its employees, agents and representatives from any and all claims of any kind that the participant, or the undersigned or their respective heirs, executors, administrators, or assigns may have or claim to have resulting from participation in said program.

*Waiver Confirmation

I HAVE READ THIS RELEASE OF LIABLILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING. I SIGN THIS AGREEMENT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Would you like to make a donation to Ocean Springs Parks and Recreation Children's Programs ?

Donation

$

How did you hear about this program

Total Due:

$

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