Basketball Player Registration Form
 
 
    
 
 
 
 
Corona Youth Basketball League
  
                                            And Tournaments
 
 
 
 
 
Team Registration Available 
 
 
 Must Have 10 Players 
 
Teams Must Have their own Jersey 
 
Registration is Only $95.00 Per Player
 
Must Provide Proof of Age for All Players 
 
 
 
Please Ask About Our Nathanael HomeSchool Academy Discount
 
 
 
 
Player Information
First Name: Middle Name: Last Name:
Gender: Date of Birth: Height:
School Attended (2017- 2018): Grade: 2017 - 2018 Age:
Parent/Legal Guardian Information
#1 Name: #1 Cell Phone: #1 Email:
#2 Name: #2 Cell Phone: #2 Email:
Address: City:    
State: Zip Code:  *    
Emergency Contact Information
Full Name: Phone: Relationship to Player:
Physician Name: Physician Phone:    
Insurance Carrier: Pollicy #:    
Medical Concerns:
Shorts/Shirt Size
Shorts: Shirt: