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2018 Youth Basketball
This form is used for Roster Creation purposes and also serves as the waiver for participation. PAYMENT ON THE SEPARATE YMCA SYSTEM MUST ALSO TAKE PLACE FOR PARTICIPATION TO BE ALLOWED.
LAST name of child
FIRST name of child
Child's AGE as of December 1, 2018? 60-minute practices are held at the Superior YMCA on Thursdays at 6:00pm for 4-5 Division & 7:00pm for 6-7 Division.
6 (1st Grade)
8 (2nd Grade)
Has your child played basketball with us before
This will be our first year!
We've played in this league before.
CHILD's t-shirt size
Youth Extra Small
EMAIL of parent
School attending this fall?
Four Corners Elem
Great Lakes Elem
Lake Superior Elem
Northern Lights Elem
Each team is led by volunteer parent/coaches. Are you able to help coach your child's team? The Y will provide you a link for online training and a small packet with practice suggestions and teaching techniques.
If YES to previous question: Have you coached youth sports in the past? (if NO to previous question, skip this and next question)
YES- other sport
What size coaches' shirt?
I hereby give my permission and approval for the above-named child to participate in all Youth Basketball activities during the 2018 season. I assume all risks and hazards incidental to such participation, and I release the YMCA, supervisors, and coaches from any claim arising from an incident or injury to my child. I also understand that the my child's photo might be used for future promotional efforts and if I object, I must communicate these wishes in an email or in writing to Jon Reimer, the YMCA's Activities Director. By answering this question, this will serve as my digital signature.
Have you already PAID the $30/$60 participation fee on the YMCA payment system?
I have/will pay in person with Superior YMCA desk staff
I have/will pay online at
The Meet & Greet is scheduled for December 15. Specific times for each division will be posted, when available, at
We'll see you there! We'll also watch our email for more M&G details.
Due to scheduling conflicts, we are unable to attend.
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