1st Through 6th Registration Form

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Riverside Youth Basketball League

Registration Form 2019-2020

Players Name: ________________________________ Age: _________ Grade:____________

Address:______________________________________________________________________

Birthday:__________________ Sex: __________ School:______________________________

Mother/guardian Name:_______________________________ cell: _____________________

Father/guardian Name:________________________________ cell:____________________

Best email address: ____________________________________________________________


Jersey Size: Youth XS S M L XL Adult S M L XL

Shorts Size: Youth XS S M L XL Adult S M L XL

Are you interested in coaching: YES NO

If yes, Name:_____________________________________ Cell:__________________________

If your child is picked for All-Stars (grades 2-5) in January, would you be willing to make the 6-
week commitment to allow them to play? YES NO

If your child is a returning player from last year, do you want them to be on the same team as
last year or enter the draft? SAME TEAM DRAFT
Registration Fee: $60.00 first child $40.00 for additional siblings
Please make checks payable to RYBL or pay with cash or card

Paid with: Cash Check #_______ Card Received By:___________________


_________________________
Wavier of Liability
I, ______________________________ (parent/guardian), am aware of the nature of this sport
and I assume responsibility of ___________________________ (player) to participate. I will not
hold the Riverside Youth Basketball League responsible in the case of an accident or injury as a
result of participation.

Signature ________________________________________ Date_____________________


Email completed form to [email protected] or mail to 19 Cross Creek Drive Belle WV 25015

Not endorsed by KCS Call/text 304-552-9753 with questions No Refunds

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