Basketball Player Registration Form
 
   Corona Youth Basketball League   
  
                                            And Tournaments
 
 
Player Information
First Name: Middle Name: Last Name:
Gender: Date of Birth: Height:
School Attended (2017 - 2018): Grade: 2017 - 2018    
Parent/Legal Guardian Information
Parent/Legal Guardian Name: Parent/Legal Guardian Cell Phone: Parent/Legal Guardian Email:
Parent/Legal Guardian Name: Parent/Legal Guardian Cell Phone: Parent/Legal Guardian 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: