Basketball Player Registration Form
Corona Youth Basketball League
                                            And Tournaments
Team Registration Available 
 Must Have A Minimum of 6 Players 
Teams Must Have their own Jersey 
Inquire For More Information
Must Provide Proof of Age for All Players 
 Cost Per Player With Out A Team is $130.00
Please Ask About Our Nathanael HomeSchool Academy Discount
Player Information
First Name: Middle Name: Last Name:
Gender: Date of Birth: Height:
School Attended (2019- 2020): Grade: 2019 - 2020 Age:
Parent/Legal Guardian Information
#1 Name: #1 Cell Phone: #1 Email:
#2 Name: #2 Cell Phone: #2 Email:
Address: City:    
State: Zip Code:  *    
Emergency Contact Information
Full Name: Phone: Relationship to Player:
Physician Name: Physician Phone:    
Insurance Carrier: Pollicy #:    
Medical Concerns:
Shorts/Shirt Size
Shorts: Shirt: