Player Information Form

* Indicates required field

Player Name *

First

Last

Grade for 2016-2017 School Year *

Gender *

Birthdate (XX/XX/XXXX) *

Parent or Legal Guardian Name *

First

Last

Phone Number *

Alternate Phone Number *

Email *

A Player or Parent / Legal Guardian (if player is under the age of 18) must acknowledge and agree to the terms of the Consent, Waiver & Release before the player may participate in any activities at Pursuit Basketball Academy.

Acknowledgement *

Yes, I have read and acknowledge and agree to the terms of the Consent, Waiver & Release.

submit

​Player Information Form

Player Information Form