Ballin Elite
Sign in to Google to save your progress. Learn more
Email *
Parent Contact E-mail *
Athlete Name (First, Last) *
Parent Contact Phone Number and Name *
Player Birthday *
MM
/
DD
/
YYYY
Uniform Size (Adult Sizes) #'s will be randomly assigned based on availability *
 Monthly Dues $190 + $60 Uniform order *
Required
Consent for Emergency Care: Be it known that in the event my child needs medical attention and I, the parent, cannot be reached, I grant the Ballin Elite and Moballin Training staff permission to make necessary decisions accordingly. I do give and grant available medical doctors or hospitals my consent and authorization to render such aid, treatment or care, in the event the above player should be injured or stricken ill while in the gym. It is understood that the insurance company for the above named player, or the parent/ guardian of the player, or combination of the two, will pay for expenses incurred. Payment for the expense will not fall upon Ballin Elite or Moballin Training staff. *
I agree to pay $190 monthly dues on either the 1st, 15th or 30th of each month. *
I agree to pay $85 for league registration once every season for the Basketball League games on Saturdays. A reminder will be sent on Group Me and payment accepted electronically. *
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report