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EDWARDSVILLE YMCA
BOYS' & GIRLS' 2ND GRADE INSTRUCTIONAL BASKETBALL LEAGUE
Winter 2008 Registration Form

Second Grade Instructional Basketball Program
This instructional league wil begin on Satruday, January 19, 2008. Boys and girls in the second grade age group are welcome to participate. Basic basketball skills will be introduced in this six-week league consisting of introductory clinics and low-organized games. An eight-foot rim height will be used. This league will be held on Saturday mornings. Print your registration form here or pick one up at the YMCA.
Fees: Members $25; Nonmembers $37
Registration Begins: Monday, November 19, 2007
Registration Deadline: Sunday, January 6, 2008
Program Begins: Saturday, January 19, 2008
Players' name:
Birth Date: Age:
Address: City:
State: Zip:
Phone: Sex: M - F
School attending this year: Grade:

Parent Name:

Email:
YMCA Member? Y - N Shirt Size (circle one): Youth:
10/12 - 14/16

Adult:
S - M - L - XL
Person to notify in case of emergency:
Name:
Phone:
Will a parent(s) be willing to volunteer as a coach? Y - N
If you marked yes, please write parent(s) name below:
Name(s):
Phone:
Email:


Parent Agreement: I agree to my child's participation in the YMCA basketball program, and that s/he will comply with all league rules and regulations. I further agree that I will not hold the YMCA, the league, its sponsors, or facility owners responsible in case of accident or injury. I fully understand that no accident insurance is provided and that I am responsible for such coverage if so desire,

Parent/Guardian Signature:_______________________________ Date:_____________

Total fee: _______ Date Paid: _______ Receipt #: _______ Staff initials: _______