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EDWARDSVILLE YMCA
GIRLS' YOUTH BASKETBALL LEAGUE
Winter 2008 Registration Form

Girl's Youth Winter Basketball League
The YMCA is offering a winter basketball league for all girls in the 3rd to 8th grades. This recreational league is open to all girls regardless of ability level. The league will begin in January with an introductory skills clinic and will continue with seven weeks of game play. League play will be held on Saturday afternoons and early evenings.
Fees: Members $35; Nonmembers $45
Registration Begins: Monday, Novmber 19, 2007
Registration Deadline: Sunday, January 6, 2008
Program Begins: Saturday, January 26, 2008
Players' name:
Birth Date: Age:
Address: City:
State: Zip:
Phone: Sex: M - F
School Attending this year: Grade:
Parent Name: Email:
Did applicant play in last year's YMCA Youth Basketball League? Y - N

Ability level/knowledge of basketball: Rating on a 1-5 point system (1=never play; 5 = always play)
1 - 2 - 3 - 4 - 5
YMCA Member? Y - N Shirt Size (circle one): Youth:
10/12 - 14/16		 Adult:
S - M - L - XL - XXL
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(s):
Name(s):
Phone:
Email:

Participation Agreement: I agree to my child's participation in the YMCA basketball program, and that she 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 desired.

Parent/Guardian Signature:_______________________________ Date:_____________

As a parent/guardian of a child that is participating in the Edwardsville YMCA Girls' Youth Basketball program, I promise that I will encourage my child to follow the YMCA Sports Philosophy, and as a parent/guardian will honor the YMCA Sports Philosophy throughout the Girls' Basketball season.

Parent/Guardian Signature:_______________________________ Date:_____________

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