ELW 2019-2020 FALL/WINTER BALL REGISTRATION FORM
Welcome to the ELW Future Stars Basketball Program

We are excited and thrilled that you are registering for the upcoming basketball season. We appreciate your interest in our program. Eddie Lee Wilkins, former NBA player, and his team of trained basketball coaches conduct the basketball program for children, ages 4 & up. Participation in the Program will improve hand and eye coordination, motor skills, court awareness, and increase foot speed. For our competitive players and teams, we will offer the opportunity for them to travel within the metropolitan area and play other competitive teams. Our goal is to teach the fundamentals of basketball correctly. The program is designed to promote teamwork, build confidence and character, and develop sportsmanship. The most important thing is we are laying the foundation for them to be successful in basketball and have fun!

FALL/WINTER LEAGUE 2019-2020

BOYS & GIRLS
AGES 4-17

November 6 - January 26
8 Week Session

Registration Fee
Before Sep 15th: $150
Before Oct 15th: $175
After Oct 15th: $190
Multiple Child Save: $20 ea

To pay your registration fee, please click the following link: http://www.paypal.me/ElwFutureStars
Email address *
PLAYER'S INFORMATION
Player's Last Name *
Your answer
Player's First Name *
Your answer
Player's Birthdate *
MM
/
DD
/
YYYY
Player's AGE as of 9/1/2019 *
Your answer
Player's GRADE as of 8/1/2019 *
PARENT/GUARDIAN #1 INFORMATION
Parent's Name (First & Last) *
Your answer
Parent's address
Your answer
Parent's Phone Number *
Your answer
Parent's Email Address *
Your answer
PARENT/GUARDIAN #2 INFORMATION
Parent's Name (First & Last)
Your answer
Parent's address
Your answer
Parent's Phone Number
Your answer
Parent's Email Address
Your answer
PLAYER'S MEDICAL INFORMATION
In the event of an emergency, who should be contacted (parents are always contacted 1st, please list another point of contact) *
Your answer
Emergency contact relationship to player *
Emergency contact phone number *
Your answer
Does your player have any allergies? *
If your player has allergies, please describe
Your answer
Does your player have any medical conditions or taking any medications that we need to be aware of? *
If your player have any medical conditions or taking any medications that we need to be aware of, please explain
Your answer
UNIFORM INFORMATION
What is your player’s jersey size? *
What is your player’s shorts size? *
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