2024/2025 Rep Tryouts Registration Form 2024/2025 Rep Registration Form - One Youth Parent/Guardian Contact InfomationName Of Parent/Guardian(Required) First Last Phone(Required)Email(Required) Address(Required) Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Information About The Youth You Are RegisteringName Of Youth(Required) First Last Date Of Birth(Required) MM slash DD slash YYYY Age As Of December 31st(Required)Are there any medical concerns we should be aware of?(Required)NoYesPlease describe the medical conditions that pertain to this registrant.Please indicate the division that matches your child's age.(Required) U10 (2015-2017) U11 (2014) U12 (2013) U13 (2012) U14 (2011) U15 (2010) U19 (2006/2007/2008) Based on age as of December 31st. of current year.Consent & Agreement To Our TermsI am the parent or legal guardian of the above-named player. I do hereby consent and agree that the said player may participate in the Brantford CYO Girls Basketball program. It is understood and agreed that the Brantford CYO Girls Basketball, C.Y.O. Basketball (Brantford) Club, it's representatives and sponsors, assume no responsibility for any injury, loss or damage incurred as a result of the player's participation in the program, or in travelling to or from program events; and I hereby release Brantford CYO Girls Basketball, C.Y.O. Basketball (Brantford) Club, it's representatives and sponsors, from any and all claims for such injury, loss or damage.Terms & Conditions Consent(Required) I have read the Terms & Conditions above and by checking this box I agree and consent. Consent is required to continue registrationI hereby agree that the above player's photograph or other visual reproduction may be used by Brantford CYO Girls Basketball and C.Y.O. Basketball (Brantford) Club in it's promotional, publicity and informational material.Photo Consent(Required) I consent to the photo release terms above I do not consent Payment InformationThe registration fee is $25. After you complete and submit this form, please submit your $25 payment via etransfer to: brantfordcyogirls@outlook.com Please note that selecting Rep League does not guarantee your child a spot on a team but will ensure that they are added to the appropriate list of tryouts. Please complete a new form for each child. Payment must be made prior to participation in the program. This information will also be emailed to you after you submit this form. Please check your spam folder if you do not receive it within 10 minutes after submitting.EmailThis field is for validation purposes and should be left unchanged.
