Basketball Individual Registration

Youth Basketball League Individual Special Registration 2024-25

I am registering(Required)

An Individual to Play for a PHUMC Team

Individual Player Information

Student Name(Required)

First Last

Student Grade(Required)

School Student Attends(Required)

Student Gender(Required)

Student Jersey Size(Required)

List of players or coaches student would prefer to play with (If you already have a team picked, please select the "Team Option")

Parent/Guardian Name(Required)

First Last

Parent/Guardian Email(Required)

Parent/Guardian Phone(Required)

Additional Emergency Contact Name(Required)

First Last

Additional Emergency Contact Phone(Required)

Signature(Required)

This is to inform those concerned that Pulaski Heights United Methodist Church will not be held liable for injury sustained as the result of basketball games during the 2025 Church Basketball League sponsored by Pulaski Heights United Methodist Church. Each player will be responsible for providing their own personal insurance to cover any injuries sustained while playing in the League during the 2025 season. Our League Rules state in rule #15 that: “this league is designed for those who do not play on a AAA sanctioned School Interscholastic Teams…” By signing below the parents acknowledge that they understand this rule and that their child is not playing for a school team. Please type your name below to confirm your understanding

PAYMENT INFORMATION

Individual Price(Required)

Price:

Total

Credit Card(Required)

Cardholder Name

Card Details

Youth Basketball League Individual Special Registration 2024-25

Individual Player Information

PAYMENT INFORMATION

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