ST PATRICK SCHOOL KENT - CYO ATHLETIC REGISTRATION FORM-Basketball
PLEASE COMPLETE THE ENTIRE FORM. YOUR REGISTRATION CANNOT BE ACCEPTED IF ANY OF THE REQUIRED FIELDS ARE LEFT BLANK .

REGISTRATION REQUIRES COMPLETION OF PRE-PARTICIPATION FORM AND HOLD HARMLESS AGREEMENT. BOTH OF THESE FORMS ARE AVAILABLE AT http://www.stpatskent.org/cyo-athletics/cyo-general-info (scroll down to Downloads & Documents)

Athlete First Name *
Your answer
Athlete Last Name *
Your answer
Guardian Name *
Your answer
Guardian Street Address *
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Guardian City *
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Guardian State *
Your answer
Guardian Zip Code *
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Guardian Mobile Phone *
Your answer
Phone - Other
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Guardian E-mail *
Your answer
Grade *
Select from the Pull-down menu
Athlete Birthdate *
Month/Day/Year
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Athlete Gender *
Athlete Religion *
Athlete Race *
Athlete Eligibility *
Athlete School *
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Athlete Parish *
Your answer
Athlete Physical Exam Date *
Month/Day/Year
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By submitting this registration, I agree to all fees associated with this sport including but not limited to participation fee($110), booster fee($20) and uniform deposit ($75)
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