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Complete this form to register for our Empire Youth Sports basketball season! If you have any questions or issues with this form email us at upandunderkidsrugby@gmail.com
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Bay Ridge Basketball Fridays @ JJ Carty Park
Child First Name:
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Child Last Name:
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Parent Name
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Child Age:
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Child´s School:
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Child Grade in School:
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Option 1
Child Date of Birth
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MM
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DD
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YYYY
Parent/Guardian Email 1:
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Parent/Guardian Email 2:
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Parent/Guardian Emergency Cell Phone Contact 1:
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Parent/Guardian Emergency Cell Phone Contact 2:
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Payment Method:
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