2018 St. Rose Basketball Tournament Registration
Please complete the following registration form and submit payment in order to confirm your team's entry into the tournament. Please submit all forms by or on Sunday, January 28, 2018.

Please also remember that payment must also be received by or on Sunday, January 28, 2018. This can be accomplished by...#1: clicking on the PayPal link (https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=Q44R3Q4HXELR6) which is also located in the coaches email packet or at http://www.stroselimaschool.org/athletics, or...#2: mailing a check payable to "St. Rose Athletics Association" to the following: St. Rose Athletics Association-Gray Hagy, 257 E. Jefferson St., New Lexington, OH 43764. If paying by PayPal, you will have to enter "$125" manually in the amount box titled "Other Amount".

Failure to submit registration and/or payment by or on Sunday, January 28, 2018 may result in forfeiture of your team's tentative registration (if applicable) thus opening registration to the next team on the waiting list. If a forfeiture occurs, re-entry may only occur after being cycled through the respective waiting list.

Please note: Withdrawal or "no shows" from or during the tournament after Sunday, January 28, 2018 will result in forfeiture of your entry fee.

If you are unable to complete this form online, please print and fill out the forms attached to the coach's email packet and mail it to the mailing address listed on the form or attach it to an email addressed to strosebasketballtournament@gmail.com. Forms can also be found at http://www.stroselimaschool.org/athletics. If you did not receive a coach's email packet and would like one, please request one at www.strosebasketballtournament@gmail.com.

Direct any questions or problems concerning the form or payment to Eddie Ward (740-605-6610); strosebasketballtournament@gmail.com

Please note that all information submitted to St. Rose Athletics is kept confidential, used only for purposes of the aforementioned basketball tournament, and will not be shared with any outside entities.

Thank you!

Team Name *
Your answer
Team Gender *
Chose from drop list.
Team Grade *
Chose from drop list
Head Coach Name *
Please include first and last name.
Your answer
Head Coach Street Address *
Please enter street number and street name.
Your answer
Head Coach City, State, And Zip Code *
Please enter city, state, and zip code
Your answer
Head Coach Cell Phone Number *
Please enter area code followed by the phone number.
Your answer
Head Coach Home Phone Number *
Please enter area code followed by the phone number.
Your answer
Head Coach E-Mail Address *
Your answer
Assistant Coach Name
Please include first and last name. Remember, only two (2) coaches are allowed on the bench.
Your answer
Assistant Coach Cell Phone Number
Please enter area code followed by the phone number.
Your answer
Assistant Coach E-mail Address
Your answer
Player #1 Name *
Please include first and last name.
Your answer
Player #2 Name *
Please include first and last name.
Your answer
Player #3 Name *
Please include first and last name.
Your answer
Player #4 Name *
Please include first and last name.
Your answer
Player #5 Name *
Please include first and last name.
Your answer
Player #6 Name *
Please include first and last name.
Your answer
Player #7 Name *
Please include first and last name.
Your answer
Player #8 Name *
Please include first and last name.
Your answer
Player #9 Name *
Please include first and last name.
Your answer
Player #10 Name *
Please include first and last name.
Your answer
Player #11 name *
Please include first and last name.
Your answer
Player #12 Name *
Please include first and last name.
Your answer
By checking this box, you are agreeing that you received and will abide by/agree to the tournament rules and regulations. *
Required
By checking this box, you are agreeing that your received and accept the provisions contained within the tournament liability release form. *
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Please indicate by which means you are submitting payment of tournament fees. *
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