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Potential Basketball Player Information
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FIRST NAME
*
Your answer
MIDDLE NAME
Your answer
LAST NAME
*
Your answer
DATE OF BIRTH
*
MM
/
DD
/
YYYY
Grade for 22-23 School Year
Choose
9th
10th
11th
12th
10 DIGIT CELL PHONE NUMBER (###) ###-####
*
Your answer
EMAIL ADDRESS
*
Your answer
STREET ADDRESS
*
Your answer
CITY
*
Your answer
STATE
*
CA
Other:
ZIP CODE
Your answer
PARENT #1 FIRST AND LAST NAME
*
Your answer
PARENT #1 EMAIL
*
Your answer
PARENT#1 CELL PHONE (###) ###-####
*
Your answer
PARENT #2 FIRST AND LAST NAME
Your answer
PARENT #2 EMAIL
Your answer
PARENT#2 CELL PHONE (###) ###-####
Your answer
TOP SIZE (Jersey, Shirt, Sweatshirt, etc.)
*
Youth S
Youth M
Youth L
XS
S
M
L
XL
XXL
BOTTOM SIZE (Shorts, Sweatpants, etc.)
*
Youth S
Youth M
Youth L
XS
S
M
L
XL
XXL
Preferred Jersey Number (first choice, if available)
Your answer
Preferred Jersey Number (second choice, if available)
Your answer
Preferred Jersey Number (third choice, if available)
Your answer
Fall Sport (if applicable)
Your answer
Spring Sport (if applicable)
Your answer
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