BBA Spring 2018 Basketball Registration

* Required Fields
Printer-friendly blank form
You may register one or two (siblings) on this form.
Registration fee for one child is $600
Registration fee for the second child is $400
You may choose to pay all fees at time of registration or you may choose to pay 50% now and the remaining balance within 30 days.  Your child will not be allowed to play if the fee is not paid in full.
 Pay full amount one child (+$600.00)
 Pay half of fee now - bill me for balance due (+$300.00)
 Pay full amount 2 children (+$1,000.00)
 Pay half of 2 child fees now - bill me for balance due. (+$500.00)
Participant #1 Registration 
*Player First Name
*Player Last Name
*Current Age
*Current School
*Jersey Size
*Shorts Size
Medical conditions? If so, please let us know.
Any food allergies? Please list all!
Second Child Registration
Player #2 First Name
Player #2 Last Name
Current Age
Current School
Jersey Size
Shorts Size
Medical conditions? If so, please let us know.
Any food allergies? Please list all!
Parent/Guardian Information
*Parent/Guardian #1: Name
*Email Address
*Cell #
Parent/Guardian #2 (Name)
Email Address
Cell #
Don't type in this field
Medical Release
As a parent or guardian of the above named player(s), I hereby give my consent for emergency medical care as prescribed by a doctor or dentist to my dependent. I, the parent or guardian, agree that my child and I will abide by the rules of the Birmingham Basketball Academy's Spring 2018 Program. I furthermore hereby release, discharge, and or otherwise indemnify the league, administrators, & coaches against any claim by or in behalf of the registrant as a result of their injury in the program.
*Waiver Agreement
I have read and agree with the waiver. 
*Does your family have health insurance?
Total Due:
Important: To receive a confirmation email, please enter your email address here

Please fix the errors indicated above and try again.