Wingo Little League Basketball Sign Up
ATTENTION: 5th/6th Grade Level- Please be aware that your child may only play 4 minutes each half. We are no longer making it a rule that coaches have to clear the benches when it is time to sub. Subs/playing time are at the coaches discretion but every player will play at least 4 minutes each half

Child's LAST Name *
Your answer
Child's FIRST Name *
Your answer
Child's School *
Child's Grade *
Child's Gender *
Child's Shirt/Jersey Size *
Parent/Guardian Emergency Contact (NAME) *
Your answer
Parent/Guardian Emergency Contact (PHONE NUMBER) PLEASE PROVIDE 2 NUMBERS *
Your answer
HEALTH INSURANCE COMPANY NAME *
Your answer
HEALTH INSURANCE GROUP/PLAN NUMBER *
Your answer
HEALTH INSURANCE POLICY NUMBER *
Your answer
HEALTH INSURANCE INSURER *
Your answer
Please list any ALLERGY, MEDICATION, or MEDICAL CONDITION that the player has. (If none, please type NA) *
Your answer
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