Girls Rec Basketball Registration

May contain: ball, basketball, basketball (ball), sport, body part, finger, hand, and person

DUE December 12th 2024

Due December 12th Online Payment

3rd-6th grade girls

Please download form and bring into office or pay online.

***If you have more than one child that you have to register, please bring the form into the office. We DO NOT have the option to change the price of the online pay scale. It is $30 if you pay online no matter what. It is $25/child (if you have more than one child) when you bring form into office.

Winter 2025 Girls Bball Registration Form.docx

$30

Contact Information

Child's First Name (required)

Child's Last Name (required)

Street Address (required)

City (required)

Child's Birthday (required)

School Grade (required)

Play Travel Ball (required)

Guardian #1 Name (required)

Guardian #1 Phone Number (required)

Email Address (required)

Guardian #2 Name (if does not apply put N/A) (required)

Guardian #2 Phone Number (if does not apply put N/A) (required)

Email Address

Skill Level (required)

T-Shirt Size

Youth T-shirt Sizes (For the Child only, if Not Applicable please select N/A) (required)

Adult T-shirt Sizes (For the Child only. If you selected a Youth Size please select N/A for this option.) (required)

List any Medical Problems/Allergies (required)

I, the undersigned parent of ____________________________(Player’s name) recognize the possibility of physical injury associated with basketball, hereby release the Worland Recreation District, its officers, league coaches, organizers, referees and all associated personnel against ANY claim by or for the registrant as a result of the registrant’s participation in the program. As the parent or legal guardian of the above-named player, I hereby give consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb, or well-being of my dependent.

Your Signature (required)

Confirm e-Signature

Review Electronic Records and Signatures Policy (required)

Read our Electronic Record and Signature Disclosure

I agree to use electronic records and signatures

COACHES NEEDED. Volunteer coaches required. If you are willing to coach please indicate below. If you are selected as a coach your registration fee will be refunded. If we don’t have enough coaches that means more players per team and less playing time. Only your own child may be requested for your team. Please make checks payable to Worland Soccer Association. (required)

DUE December 12th 2024

$30

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