Basketball Signups - Landon's Library

Please note: these sign-ups are for 4th & 5th Graders (for 1st, 2nd, & 3rd Grade Sign-ups, please use the Southern Dribbler’s Form)

2022/2023 Youth Basketball Registration Form

"*" indicates required fields

Hidden

Date*

Parent/Guardian Names*

Parent/Guardian Cell Phone*

Parent/Guardian Email Address*

List any medical conditions/allergic reactions for your child(ren) that we need to be aware of:

Parent or Guardian Signature*

Registration Info

How many children are you registering?

Registration Fee*

Select the number of children you are registering using the dropdown. Each child registered costs $50.

Price:

Children Information*

Youth basketball registration is for 4th and 5th grade children. For 1st, 2nd, and 3rd graders, please use the dribblers form. For each child you are registering, please enter their information below. For T-Shirt sizes, please enter: YS, YM, YL, YXL, SM, M, L, or XL

Child's Name

Age

Birthdate

Grade

T-Shirt Size

Become a Sponsor

Be a Sponsor?

Sponsorship Details

If you would like to become a sponsor, the cost is only $100 for the entire season and 100% of the sponsorship money will go towards equipment, referee pay, and special events for the kids.

Price:

Business Name

If you are becoming a sponsor and would like your business name recognized, please enter your business name here.

I would be willing to participate in the following way:

Coach

Referee

Year-End Party

Total

THIS IS THE TOTAL THAT YOUR CREDIT CARD WILL BE CHARGED

Credit Card*

Card Details

Cardholder Name

Name

This field is for validation purposes and should be left unchanged.

14700