Test page 2

Welcome to Basketball Registration!

Choose the type of sign up:

Men's League Only

Children/Youth League Only

Men's League & Children/Youth Leagues

Men's League Information

Adult Player Name*

First

Last

Adult Player Email*

Adult Player Phone*

Area Code

-

Phone Number

Men's League Jersey Information

Children/Youth League Information

Parent/Guardian Information

Name - Parent/Guardian*

First

Last

Phone-Parent/Guardian

Area Code

-

Phone Number

Parent/Guardian Email*

Please indicate how many Children/Youth League Players you would like to register.

Choose:

1

2

3

4

Child/Youth #1

Name 1*

First

Last

#1 Child/Youth Grade*

Date of Birth 1*

Gender 1*

Female

Male

Child/Youth #2

Name 2*

First

Last

#2 Child/Youth Grade*

Date of Birth 2*

Gender 2*

Female

Male

Child/Youth #3

Name 3*

First

Last

#3 Child/Youth Grade*

Date of Birth 3*

Gender 3*

Female

Male

Child/Youth #4

Name 4*

First

Last

#4 Child/Youth Grade*

Date of Birth 4*

Gender 4*

Female

Male

Additional Contact Information

Please list someone we can contact if the above parent/guardian cannot be reached.

Name - Emergency Contatct*

First

Last

Phone-Emergency Contact*

Area Code

-

Phone Number

Media Release

Do you give permission your child(ren)’s photos to be taken and used on EPC website, social media, and other media publications? *

Yes

No

Church Affiliation

Easley Presbyterian members please put "EPC" in the box below. Non-members please put where you are attending church or "none" if you do not attend a church regularly.*

When you submit this form, it will redirect to our PayPal page, where you may pay with a credit card or your PayPal account. If you do not wish to pay online, please just close the page. You may pay directly to the church by cash or check.

Total

Registration for Church Basketball runs through October.

Welcome to Basketball Registration!

Men's League Information

Men's League Jersey Information

Children/Youth League Information

Parent/Guardian Information

Child/Youth #1

Child/Youth #2

Child/Youth #3

Child/Youth #4

Additional Contact Information

Media Release

Church Affiliation