Basketball League 2017 - Registration Form
Mailing Address: 117 Chatillon, Dollard Des Ormeaux, Quebec, H9B 1B4
Telephone Number: 514-941-8404
E-mail: evan@sport-life.ca
Website: www.sport-life.ca
PLAYER
Team Name
Your answer
First Name
Your answer
Last Name
Your answer
Gender
Required
Age
(as of January 1, 2017)
Your answer
Date of Birth
MM
/
DD
/
YYYY
Home Address
Your answer
City
Your answer
Postal Code
Your answer
School
Your answer
Grade
Your answer
PARENTS
Mother's Name
Your answer
Father's Name
Your answer
PHONE NUMBERS & E-MAIL
Home
Your answer
Mother Work Phone
Your answer
Mother Cell Phone
Your answer
Mother E-mail
Your answer
Father Work Phone
Your answer
Father Cell Phone
Your answer
Father E-mail
Your answer
LANGUAGES
First Language
Your answer
Languages Spoken
Your answer
Is there any other information that you think we should know about?
Your answer
PLAYER PROFILE
Please send us a digital picture of your child as well as the following information to complete their online player profile
Height
Your answer
Weight
Your answer
Favourite NBA Team
Your answer
Favourite NBA Player
Your answer
Favourite Pre-Game Meal
Your answer
HOW DID YOU HEAR ABOUT US?
Required
REGISTRATION PAYMENT
Method of Payment
e-Transfer (preferred), cheque or cash
Your answer
Name on Cheque
Your answer
Cheque #
Your answer
Amount
Your answer
TERMS & CONDITIONS
The parties hereto have agreed that this agreement be prepared and executed in the English language.
Les parties ont convenu que cet accord soit préparé et exécuté dans la langue anglaise.
Parent's Name
Your answer
E-mail Address
Your answer
Date
Your answer
Submit
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