Winter 25-26 PYBA Player Registration

Winter 25-26 PYBA Player Registration

Fill out the form carefully for registration
Participant's Name*

First NameMiddle NameLast Name
Age (As of 7/31/25)*
Age Division Request*
Birth Date*

MonthDayYear
Current Grade*
School Currently Attending*
Jersey Number 1*
Jersey Number 2*
Jersey Number 3*
Jersey Size*
Shorts Size*
Preferred Position *
Coach Request
Teammate Request
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent's Name*
E-mail*
example@example.com
Mobile Number*
Participant's Allergies*
Participant's Medical Conditions*
Name of Participant's Physician*
Physician's Number*
File Upload - Birth Certificate

Cancelof
File Upload- Participant Head Shot Picture

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Refund Policy*

I understand there are no refunds after November 1!
Bylaws/Code of Conduct Agreement*

I agree to the rules and regulations that govern your organization.
WAIVER OF LIABILITY RELEASE FORM
I am aware of the nature of this sport and I hereby assume responsibility for blanks* (Participant Name) to participate and to be photographed for publicity purposes. I will not hold the PANTHERS YOUTH BASKETBALL ASSOCIATION and/or its coaches responsible in the case of accident or injury as a result of this participation. I understand that this completed form must be in the possession of the PANTHERS YOUTH BASKETBALL ASSOCIATION prior to participation in this program.
Registration Fees-

Early Registration(before November 1):

$225 6U

$300 8U/10U/12U/9-12 GIRLS

Registration(due November 30):

$250 6U

$325 8U/10U/12U/9-12 GIRLS

Multi Participant Discount:

2+ $10 off each participant

3+ $25 off each participant

(contact Coach Gray at 832-609-3471 for discount)
Signature*

Clear
Date*

MonthDayYear
Date

Payment Options*

Basketball Registration(7-12 YEARS OLD)8U/1U/12U/9-12 GIRLS

$325.00 Quantity

Basketball Registration(6 YEARS OLD AND UNDER)6U

$250.00 Quantity

Payment Plan(Deposit Required)

$25.00 Quantity

Enter coupon

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Credit Card

Cash App Pay

Afterpay

WAIVER OF LIABILITY RELEASE FORM