Middle School Basketball : Our Sports : Sports : Terre Haute Boys & Girls Club

Middle School Basketball Registration only for 6th-7th grade boys who made their Middle School teams

6th-7th Boys Middle School League Teams (for boys who made their Middle School Teams)- $65 Registration Fee. Registration begins December 1st - December 30th. League begins Jan. 8th.

Name

First Name *

Last Name *

Address

Country

Address Line 1 *

City *

State/Province *

Postal Code *

Phone (Required)

Grade (Required)

Gender (Required)

School (Required)

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Age (Required)

Date of Birth (Required)

Shirt Size (Required)

Parent/Guardian

First Name *

Last Name *

Parent/Guardian Phone (Required)

Parent/Guardian Email (Required)

Would You Like To Coach (Required)

Coach Request (Will try to honor)

Height

Weight

Medical Condition (Required)

Please explain Medical Condition

Electronic Signature of Parent or Guardian (Required)

Date

Month

Day

Year

Email Address for Confirmation of Submission (Required)

OnlineBasketball Program Cost

$5.00 processing fee included

70.00

Your total payment will be

Your credit balance will cover

Your credit card will be charged

Your bank account will be charged