Kids Basketball 2026 4th thru 5th Grade

Please fill out this form and click submit.
Registration closes Friday, August 21, 2026 or when the age group is full.
Spots are limited so please register soon.

Child's Name

Date of Birth

Child's Gender

Please select all that apply.

Boy Girl

Grade- Please Select One Option

Please select one option.

4th Grade 5th Grade

School

We will have practice on Monday, Tuesday, and Thursday evenings. Please check all days that your child would be available and we will try to be as accommodating as possible.

Please select all that apply.

Monday Tuesday Thursday

Shirt Size

Please select one option.

Youth XS Youth S Youth M Youth L Youth XL Adult S Adult M Adult L Adult XL

Does your child have an allergy or dietary concern, physical need, learning difference or other diagnosis you would like to share with us so we are prepared to help him/her feel as safe and comfortable as possible?

Please select one option.

Yes No

If yes, please share any information you are comfortable with to help us better understand your child’s needs.These questions are asked for the benefit of your student, so we can provide the best experience and safest environment for everyone involved. Our ministry leaders and volunteers take very seriously your family's right to privacy. Any information shared from this form is communicated directly with those caring for your student and only on a need to know basis.

This address will receive a confirmation email

Parent/Guardian Name and Relationship to the Child

Phone

What is the best way to contact you? (Please Choose One)

Please select all that apply.

Phone Call Text Message Email

Physical Address

Mailing Address If Different

Do you attend Church? If so where?

League Payment $30.00

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

Please fill out this form and click submit.
Registration closes Friday, August 21, 2026 or when the age group is full.
Spots are limited so please register soon.

Kids Basketball 2026 4th thru 5th Grade

Description

Please Fix the Following