Registration Form
Last Name
First Name
Address
Apt#
E-mail
City
State
Zip Code
Birthday
Age
Participant Information
Gender
School
Grade Level
Phone
Family Doctor
Medication Y/N
If Yes, What Kind and What For?
Physical/Medical Restrictions
Explain.
Parent/Guardian Information
Choose the Camp/Clinic You are Registering For:
(ex.-00/00/0000)
Last Name
First Name
Address
Apt#
E-mail
City
State
Zip Code
Phone
Cell
Last Name
First Name
Address
Apt#
E-mail
City
State
Zip Code
Phone
Cell
Parent/Guardian
Parent/Guardian
In case of an emergency and alternative pick-up list please notify:
Name
Relationship
Phone
Name
Relationship
Phone
As parent or guardian of the applicant, I hereby accept the condition of enrollment and give my child permission to participate in the Pearland Biddy Basketball Association. I agree to comply with all program regulation, and hereby release Eden Covenant Ministries, Pearland Biddy Basketball Association, and any of it affiliates, staff, officers, and board members from any and all liability for injury or damages incurred while involved with this program. Pearland Biddy Basketball Association retains the rights to any photographs or video tapes of the campers and/or league players taken at the camp or during the season to be used for publicity or advertising.
Required Fields
*See League Info link for more information.
