Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Basketball player's name *FirstLastGrade *3rd4th5th6th7th8thHigh School Stripe charge: Size, Are you over 18?YesNoParent/Guardian's name *FirstLastParent/Guardian email *Parent/Guardian phone *AddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePermission & agreement *I agree and give my permissionIn case of illness or accident, I authorize emergency treatment by qualified medical personnel and permit the person in charge to take my child to seek necessary medical care. I consent to the facility securing all required emergency medical care for my child.I agree to pay the following charge: *Partial Pay - $250.00Boxers (Full) - $500.00Boxers Elite (Full) - $550.00Partial Pay (2nd) - Elite - $300.00Uniform (if needed) - $130.00Total$0.00Uniform Size, if neededYouth SmallYouth MediumYouth LargeYouth XLSmallMediumLargeXLXXLStripe Credit Card *Submit
