LISLE PARK DISTIRCT

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LISLE PARK DISTRICT YOUTH BASKETBALL PLAYER INFORMATION FORM Chose Division: nd

th

1/2 Boys

5/6th Boys

3/4 Boys 1/3rd Girls

4/5th Girls

Player’s Name

7/8th Boys 6/8th Girls

Gender:

Parents/Guardian Names______________________________________ Address ____________________________________________________ City ___________________Email (req) Home Phone _______________ Cell Phone Grade ___________

Date of Birth

Height___________

School Name _________________________ Any Physical Problems?

Yes ______

No _____

If yes, please explain __________________________________________ IF YOU DO NOT NEED A JERSEY BECAUSE YOU WILL BE USING ONE FROM LAST YEAR, CHECK THIS BOX  Jersey Size (circle one) YS

YM

YL

AS

AM

AL

AXL

TEAM REQUESTS WILL NOT BE TAKEN. Is there a day your child can’t practice?

I WOULD LIKE TO HELP COACH (please include your first name): ____________________

Coach (no experience necessary)

____________________

Assistant Coach

2 coaches per team maximum….One head and one assistant

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