1 On 1 King and Queen of the Court Registration



Please provide information for our records.
The requested information will be used for team management,
as well as contact and athlete information submitted for tournaments.

Student Athlete Name:(*)
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Street Address:(*)
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City:(*)
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State:(*)
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Zip:(*)
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Email:(*)
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Cell Phone:
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Date Of Birth
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Home Phone:
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Age: (*)
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Shirt Size:(*)
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AAU#:
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Student Athlete Grade:(*)
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School (include city):(*)
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Father/Guardian Name:
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Phone:
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Email:
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Mother/Guardian Name:
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Phone:
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Email:
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Best Contact For Last Minute Changes:(*)
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I, do hereby give my child permission to participate in the Youth Basketball Development Leagues Program. Therefore, I do not hold Youth Basketball Development Leagues personnel or its affiliates liable or responsible for any harm or injury that may occur before, during, or after practice, games, tournaments and the like. I authorize the use of the information listed above for league and tournament registration, team rosters, distribution to other players and parents of Youth Basketball Development Leagues.

Please enter the full name of the student athlete here:(*)
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Parent/Guardian Electronic Signature (Please Enter Your Full Name)(*)
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Date: (Click to select)
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Parent/Guardian Electronic Signature (Please Enter Your Full Name)(*)
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Date: (Click to select)
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By checking this box you agree that all electronic signatures within this form are legal and binding(*)
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Registration Fee $30

You will be directed to Paypal after you click the submit button.

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