Basketball Registration Form

Use the Basketball Registration Form below to register your child for Second Baptist Church CYO teams.

The registration fee is $65 (as long as a parent volunteers at 4 home games).  Send the check made payable to “Second Baptist Church” to Second Baptist Church, 589 Granby Rd, South Hadley, MA 01075.

Player's Name (required)

Grade (required)

Date of Birth (required)

Gender (required)

Medical disclosures (if none, please state none) (required)

Mom's Name (required)

Mom's Address (required)

Mom's Telephone (required)

Mom's Email (required)

Dad's Name (required)

Dad's Address (required)

Dad's Telephone (required)

Dad's Email (required)

Emergency contact info if not mom or dad (required)

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