Harrison Youth Basketball 4th-6th Registration Form

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Harrison Youth Basketball registration is open for students in grades 4th-6th. Practices will start at the end of November 2026 with a game schedule running approximately 6 weeks on Saturdays starting in January 2027. Commitment includes 2-3 practices per week. Athletes will need their own transportation to and from locations. Registration Cost is $50 per player ($150 max per family). This registration cost covers the cost of personalized jerseys with shorts. Payment (cash or check) can be turned into Larson Elementary School Office or Harrison Middle Office during school hours. You can also pay by debit/credit card by calling Harrison Business Office at 989-741-8195 between 7:30 a.m.- 2:30 p.m. Monday-Friday. Registration will be open until October 20th 2026. Registration will need to be paid in full no later than October 20th. Without a paid registration there will not be a jersey ordered for the registered athlete and they will not be added onto the roster. Please make sure to fill out this form and send your payment in. We are looking forward to a great season!

Grade Level *

4th

5th

6th

Gender *

Male

Female

Players First Name *

Players Last Name *

Date of Birth *

YYYY

Allergies/medical concerns *

Parent/Guardian Name (1) *

Parent Guardian Phone Number (1) *

Parent/Guardian Name (2) *

Parent/Guardian Phone Number (2) *

Emergency Contact Name *

Emergency Contact Phone Number *

Preferred Jersey Number *

Preferred Jersey Number if option 1 unavailable *

Jersey Top Size (Unisex) *

Youth SM

Youth MD

Youth LG

Youth XL

Adult SM

Adult MD

Adult LG

Adult XL

Short Size (Unisex *

Youth SM

Youth MD

Youth LG

Youth XL

Adult SM

Adult MD

Adult LG

Adult XL

Throughout the season photos and videos may be taken of players during practices, games, and team events. These images may be used by Harrison Youth Basketball for purposes such as: team posters, flyers, social media post or school content. Please check your preference below. *

I GRANT PERMISSION for Harrison Youth Basketball to use my child name, image, and/or likeness in photos and videos for program-related purposes as described above.

I DO GRANT PERMISSION for Harrison Youth Basketball to use my child name, image, and/or likeness in photos and videos for program-related purposes as described above.

I acknowledge the risks of injury associated with participation in sports. I agree to release, indemnify, and hold harmless Harrison Youth Basketball, its agents, officers, and employees from any liability claims or demands which arise for my child's participation in basketball. *

Agree

Disagree

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