This Form cannot be submitted until the missing
fields (labelled below in red) have been filled in
REGISTRATION with PAYPAL
Please note that all fields followed by an asterisk must be filled in.
I am registering for the following session:
SUMMER CAMP - #1 ADVANCED
SUMMER CAMP - #2 BEGINNING/INTERMEDIATE
SUMMER CAMP - #3 BEGINNING/INTERMEDIATE
SUMMER CAMP - #4 BEGINNING/INTERMEDIATE
Player's First Name*
Player's Last Name*
Home Phone (e.g. 408-777-1234 )
Mobile Phone (e.g. 408-777-1234 )
Current Grade Level*
Height - feet
Height - inches
Health Policy Number*
Emergency Contact Name:*
Emergency Contact Phone #*
Agree to Use Internet Acces*
Approval to Post Child's Name (Roster and Verification)
I am ordering a new jersey (Jersey required for League play only, NOT Summer Camps)
Current Jersey Number
All players who register will agree to “Re-Evaluation,” our process of shifting players between teams to ensure that the talent in the league is fairly balanced. This team balancing will occur after the first two league games, which we hope to accomplish with the minimal amount of stress for all. Please click on the " Yes" button below to agree to team balancing or “Re-Evaluation.” (REQUIRED)
I would like to be considered to coach. If I volunteer to coach I agree to allow SCBA to conduct a confidential background check. The SCBA is dependent on competent and positive coaches volunteering their time and energy.
I understand that the SCBA is dependent on volunteer coaches, and that the SCBA reserves the right to use high school age coaches if a qualified adult coach is not available.
Understood and Agreed Upon
Last Name of Person Making Payment for this Application
Emails of other names to send information updates (like scores and schedule etc).
Please enter the word that you see below.
SCBA Basketball Academy Copyright 2016 firstname.lastname@example.org