*Player's Name:

*Players' Birthdate January February March April May June July August September October November December 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988

*Player's School Grade 12 11 10 09 08 07 06

*Player's School Name:

Parent(s) Name:

Street Address:

City/State:

Zip Code:

Home Phone:

Work Phone:

Cell Phone:

*Which phone to best be reached with?

*Email Address:

Yes.....My child has played AAU basketball before.

If Yes, please list details (team, coach, year, etc.):

I am interested in:

Individual Workouts

Playing on a Team