Community Education 3rd-8th Grade Boys and Girls Basketball Registration Form
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Email *
Participant's First and Last Name *
Participant's Birthdate (Student's Only) *
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Participant's Grade for 2021-2022 School Year
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Program
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Last Name of Classroom or Advisory Teacher
Jersey Size *
Shorts Size
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Warm Up Shirt
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Last Name on Back of Warm Up Shirt (Please spell correctly as that is what will be ordered)
Community Ed is seeking volunteer coaches for our basketball teams.  If your a parent who is interested in coaching, please note that below.  Please write in the "other" box the name and cell phone number of individual interested in volunteering.
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Parent First and Last Name (#1)
Parent Email Address (#1)
Cell Phone Number Parent #1 (10 digit phone number) *
Parent First and Last Name (#2)
Parent Email Address (#2)
Cell Phone Number Parent #2 (10 digit phone number)
Allergies (If none, please write NA) *
I give/do not give permission for photos or videotapes of my child to be reproduced for DGF promotional or educational purposes.   *
I, the undersigned, will assume responsibility in case of accidents, injury or lost or damaged personal items during the program’s duration. *
I have read the Parent Code of Conduct and Liability Waiver form and agree to follow those guidelines.
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My payment will be submitted via: *
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