Youth Basketball League

"*" indicates required fields

1st-6th grade basketball league. Game dates are December 7, 14, 21 and January 11, 18, 25. 1st/2nd grade teams are co-ed and will play in Clearwater only (four team minimum). 3rd-6th grade teams are split between boys & girls and will play games in Clearwater, Haysville and Mulvane.

Youth Basketball League

Child's Name*

First Last

Team selection*

Player shirt size*

Willing to coach*

Parent/Guardian's Name*

First Last

Parent/Guardian's Phone (area code + phone number)*

Parent/Guardian's Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Parent/Guardian Signature*

Total

This includes online convenience fee and $10 late fee.

Payment Method

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Comments

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