Initial Registration

INITIAL
REGISTRATION FORM

PLAYER INFORMATION

FULL NAME:

SCHOOL NAME:

GRADE:

DATE OF BIRTH:

STUDENT CELL PHONE:

STUDENT EMAIL:

STREET ADDRESS:

CITY/STATE/ZIP:

PARENT NAMES:

PARENT EMAIL 1:

PARENT EMAIL 2:

PARENT CELL 1:

PARENT CELL 2:

BASKETBALL INFORMATION

PRIMARY POSITION:

SECONDARY POSITION:

DEXTERITY:

Right Handed

Left Handed

Ambidextrous

HEIGHT: (FT / IN)

WEIGHT: (LBS)

PREVIOUS INJURIES:

APPROX PREV INJURY DATE:

CURRENT INJURIES:

APPROX CURRENT INJURY DATE:

HOW DID YOU HEAR ABOUT US?:

SECURITY: