Youth Basketball League Test

Youth Basketball League Registration 2027

Sign up a team for the Youth Basketball League. Please fill out the following form to reserve your spot(s) for the 2027 PHUMC Youth Basketball League. The rules can be found below. If you have any questions please call Heather Doherty at 501-664-3600 or hdoherty@phumc.com. The deadline to sign up is October 15.

I am registering(Required)

An Individual to Play for a PHUMC Team

For a Team

For a PHUMC Team (Note: coach must be a PHUMC Member)

PHUMC TEAM INFORMATION

Coach must be a PHUMC member. Jerseys will be provided by PHUMC.

Division(Required)

Coach Name(Required)

First Last

Coach Phone Number(Required)

Coach Email(Required)

CHURCH/SYNAGOGUE INFORMATION

Name of Church/Synagogue(Required)

Church/Synagogue Contact Name(Required)

Note, this must be a person employed by the church/synagogue. This is used to verify the team is actually from this church/synagogue and they will be contacted by the league to verify that the coach can represent this church/synagogue and will be contacted should any issues arise.

Church Contact Phone(Required)

Church Contact Email(Required)

TEAM INFORMATION

Division(Required)

Coach Name(Required)

First Last

Note, if you don't have a coach yet, put the church contact in this spot.

Coach Phone Number(Required)

Coach Email(Required)

ROSTER INFORMATION

Please submit your roster as much as you know below. If you need to make any changes or submit your roster at a later time you can. Please note: A player who is not on the roster cannot play in the league. All students will need to fill out a liability waiver which can be found at phumc.com/liability and will be emailed to you upon completion of this form. Team size is up to you. Just make sure you have enough to avoid frequent forfeits. DEADLINE TO FILL OUT A ROSTER IS JANUARY 4, 2027.

List

Player Name

Emergency Contact Name

Emergency Contact Number

Individual Player Information

Individual registration does not guarantee team placement and refunds will be issue if we cannot place

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 2027 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 2026 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

Price:

Coupon Code

Team Price(Required)

Price:

Total

Credit Card

Cardholder Name

Card Details

Youth Basketball League Registration 2027

PHUMC TEAM INFORMATION

CHURCH/SYNAGOGUE INFORMATION

TEAM INFORMATION

ROSTER INFORMATION

Individual Player Information

PAYMENT INFORMATION

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