Please complete one form per child registered. Basketball Participant Details Please complete a unique form submission for each child participating in the program. Child Team RegistrationChild's Name* First Last Team/Coach* 1/2 Grade Coed (Brown) 3/4 Grade Girls (Coburn) 3/4 Grade Boys (Scherrer/TBD) 5/6 Grade Girls (Parkes) 5/6 Grade Girls (Willard) 5/6 Grade Boys (Remsburg) 5/6 Grade Boys (Willard) 7/8/9 Grade Girls (Grant) High School Boys (Parkes) Please choose your team and coach.Allergies or Special Needs List any allergies or special needs of your child that we should be aware of. Leave blank if not applicable.Emergency Medication* Yes No Does your child carry/use an EpiPen or Auvi-Q?Shirt Size* Youth Small Youth Medium Youth Large Youth Extra Large Small Medium Child’s shirt size for jerseyContact InformationPrimary Parent Email* Additional Parent Email (optional) If you want multiple parents to receive team emails, enter additional address here.Individual(s) Authorized for Pickup Full names of individuals authorized to pick up child, other than parentsEmergency Contact* First Last Individual to be contacted in emergency if parent(s) unavailableEmergency Contact Phone*