BBA Spring 2020 Elite Academy Registration

* Required Fields
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You may register one or two (siblings) on this form.
Registration fee for one child is $350
Registration fee for the second child is $275
*CHOOSE PAYMENT OPTION
 Payment for 1st Child (+$350.00)
 Payment for 2 children (+$625.00)
Participant #1 Registration 
*Player First Name
*Player Last Name
*Grade
*Current School (use shortest name possible!)
*Jersey 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
Grade
Current School (use shortest name possible!)
Jersey Size
Medical conditions? If so, please let us know.
Any food allergies? Please list all!
Parent/Guardian Information
*Parent/Guardian #1: Name
Don't type in this field
*Email Address
*Cell #
Parent/Guardian #2 (Name)
Email Address
Cell #
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 Elite Academy. 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?
 Yes 
 No 
Total Due:
$ 
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