Registration #: Grade:

(To be assigned at the tryout)

Player Information

Last Name: First Name:

Address: City: Zip code:

Phone Number: Birthday:

Email Address:

Current School: Planned High School:

How many years have you played organized basketball?

What league(s) did you play in last year?

List other sports you play:

List other sports you participate in during the winter:

Favorite Sport:

Father’s Name: Phone Number:

Mother’s Name: Phone Number: