Players’ Full Name:

Birthday:

School (for next fall):

Grade:

Player’s E-mail:

Player’s Cell Number:

Home Address(es):

Home phone number(s):

Mother’s Name:

Mother’s Work Number:

Mother’s Fax Number:

Mother’s Cell Number:

Mother’s E-mail:

Father’s Name:

Father’s Work Number:

Father’s Fax Number:

Father’s Cell Number:

Father’s E-mail:

Height:             Weight:

Shoe size:        Jersey size:

                         Jersey #:

How many yrs have you played basketball?

What position have you played?

What position would you like to play?

How many years have you played AAU basketball?

What positions have you played?

What AAU teams have you played for?

List of Medical Conditions (if you have asthma, anything exercise induced, or anything that would affect your playing, please describe in detail what to do in case of an emergency):

Emergency Contact Names and Number(s):