Ballmatics Rep 2021-2022 | Proven Youth Basketball Club and Basketball League

REGISTRATION FORM BALLMATICS ELITE 2021-2022

Welcome back for another season of high performance BallMatics Elite basketball and academic excellence!

We are excited to have you back with us as our first athletes to utilize our amazing new athletic and academic facility, The BallMatics Centre!

Please complete the form below to register, pay your initial deposit and secure your student-athlete’s spot on the team. We look forward to an amazing season of competitive basketball and academic enrichment!

Student Athlete's Name (First, Last) (required)

Student Athlete's Date of Birth (required)

School Name (required)

Grade (required)

Choose Your Student-Athlete's Team (required)

Jersey Size

Shorts Size

Jersey Number (please write up to three (3) number selections)

Parent/Guardian Name (First, Last) (required)

Phone Number (required)

Email Address (required)

Full Address

Please list any medical condition(s), including any requiring medications (ex. Diabetes, Asthma, Seizures)

Emergency Contact

Emerg. Name

Emerg. Phone Number

Relationship to the Player

PAYMENT
A DEPOSIT OF $400 MUST BE PAID UPON SUCCESSFUL REGISTRATION IN ORDER TO RESERVE YOUR CHILD'S SPOT ON THEIR TEAM.

You can pay by VISA or MC by clicking the register button below or if you prefer to send an EMT, please send to info@qsla.ca

TERMS AND CONDITIONS

CANCELLATIONS MUST BE MADE IN WRITING TO QSLA – Attention: Program Director.
WITHIN 30 DAYS OF THE PROGRAM START DATE OR THEREAFTER, NO REFUND WILL BE ISSUED.
PROGRAM FEES MUST BE PAID IN FULL IN ORDER TO PARTICIPATE IN ANY TOURNAMENTS.

I have read, understand and agree to the terms as stated above.

REGISTRATION FORM BALLMATICS ELITE 2021-2022

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