WELCOME TO HOUSE LEAGUE REGISTRATION
Fall 2024

Player's First Name

Player's Last Name

Date of Birth

Player's Prior Experience
—Please choose an option—NoneSchoolHouse LeagueSteve Nash - BGCKLSummer CampRep

Gender
—Please choose an option—MaleFemale

T-Shirt Size
—Please choose an option—Youth SmallYouth MediumYouth LargeYouth XLAdult SmallAdult MediumAdult LargeAdult XL

Medical Conditions

Player's Street Address

Player's City

Player's Postal Code

Parent/Guardian Name (First & Last)
 

Email Address
please list the email address that you use regularly

Secondary Email Address

Cell Phone Number

Home Phone Number

Additional Emergency Contact Name (First & Last)

Relation

Additional Emergency Contact
Cell Phone Number

Additional Emergency Contact
Home Phone Number

Additional Children
noyes

LWBA Policy Disclosures

Limited Liability Policy: Liability of the LWBA and/or any of its officials, affiliates, sponsors, or executive members, does not extend to any form of injury, damage or loss resulting from any accident, from known or unknown conditions, handicap, or infection caused while participating in or traveling to or from any LWBA activity.

Photographic Image Policy: Photographic images taken of LWBA houseleague players during practices or in the promotion of the LWBA, may be used at the sole discretion of the LWBA, along with the use of the player's name.

Refund Policy: Refunds will be considered on an exception basis and may be granted at the sole discretion of the LWBA.

Parent / Guardian Acknowledgement: I hereby acknowledge that I have read the above disclosures and my signature indicates my agreement and consent with these terms.

Other Information or Comments

Any registrations received once the spaces are filled for each age group, will be placed on a waitlist. If payment is not received with registration, your child's name will be added to the waitlist.