2021 Wyoming Valley Clutch Summer Basketball League - Individual Registration
Boys and Girls Divisions / Cost $90 includes Reversible Jersey
Leagues based on Grade Level for the 2021-2022 School Year
6 Game Season

For more information contact:
Chris Shovlin @ 570-235-8780 or Dave Jannuzzi @ 570-574-1865
Email *
Player Information
First Name *
Last Name *
Gender *
Jersey Size *
Grade *
Date of Birth *
School *
Street Address *
City *
State *
Zip Code *
Parent/Guardian *
Phone Number *
Emergency Contact (Name) *
Emergency Contact Number *
Special Requests
Waiver
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 *
Required
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