T-SHIRT SIZE:

 

Youth Small _____

Youth Med ______

Youth Lg._______

Youth XL _______

Adult sizes _______

 

 
 


Gallatin Co Youth Sports Association

Sports Registration Form

P.O. BOX 644

WARSAW KY 41095

 

BASKETBALL    $10.00

 

 

Please only 1 child per registration form. Make additional copies as needed.

Players are only allowed to play on one team. Birth certificates may be required per age group.

 

LAST NAME_____________________________FIRST NAME_________________________MI____

 

ADDRESS________________________________CITY_______________ST__________ZIP________

 

PHONE (HOME) ____________________________OTHER____________________________

 

E-MAIL_____________________________________

 

FATHERS NAME______________________________MOTHERS NAME_______________________

 

GRADE ______            SEX (CIRCLE ONE)    M      F   BIRTHDATE____________________

 

* SEE AGE GROUPING CHART TO DETERMINE AGE DIVISION YOUR CHILD WILL PLAY IN:

 

Preschool/Kindergarten     1st/2nd      3rd/4th     5th/6th    7th/8th     9th-12th

 

List any medical conditions______________________________________________________________________

 

Please indicate if you can help in one or more of the following areas.

___Coach       ___Asst Coach      ___Referee      ___Asst Referee      __Floor preparation     ___Concession Stand

 

Name______________________________________Phone______________________

E-mail________________________________________________________________

 

The Child above has my permission to participate in Gallatin Co Youth Sports Association activities. I hereby release GCYSA from any liability for injury or loss that may result from such participation. I also understand that this is a recreational sport and any unsportansmanlike behavior will not be tolerated from players or parents. Coaches will also have the right to dismiss a player from the team for offensive behavior at practice or a game. Coaches will also be responsible for parents behavior, so remember you are here for the children.

 

Parent/Guardian Signature____________________________________________________Date_____________________

 

MAKE CHECKS PAYABLE TO:  GCYSA

IF YOU NEED ANY ADDITIONAL INFORMATION PLEASE CALL 567- 5900

 

 

 

FOR REGISTRAR PURPOSES ONLY

PAYMENT RECEIVED: _________________________AMOUNT______________________CHECK#_______________________

ASSIGNED TO __________________________________________________

 

 

Fees are to help with expenses to run the sport. Please remember we will keep cost for all sports to a minimum .