2021-2022 Teenage Basketball League
9th Grade - 12th Grade
Individual & Team Registrations Accepted
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Email *
Player Information
First Name *
Last Name *
Gender *
Shirt Size *
Grade *
Date of Birth *
School *
Street Address *
City *
State *
Zip Code *
Parent/Guardian *
Phone Number *
Emergency Contact (Name) *
Emergency Contact Number *
Special Requests
I , the parent/guardian of the registrant, a minor, do agree and will abide by all the rules of the Wyoming Valley Clutch LLC & Catholic Youth Center (CYC). l recognize the possibility of physical injury associated with participating in Wyoming Valley Clutch LLC & CYC sponsored activities, and in consideration for the Wyoming Valley Clutch LLC & CYC providing these activities, do release the Wyoming Valley Clutch LLC & CYC and its staff members from all liability for any injuries sustained while on CYC property and/or participating in CYC activities.
Waiver Acceptance *
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