Winter 26-27 PYBA Registration

Winter 26-27 PYBA Registration

Fill out the form carefully for registration
Participant's Name

First NameMiddle NameLast Name
Gender
Age (As of 7/31/26)
Birth Date

MonthDayYear
Grade For 2026-2027 School Year
School Currently Attending
Jersey Number 1(Cheer Select 0)
Jersey Number 2(Cheer Select 0)
Jersey Number 3(Cheer Select 0)
Uniform Top Size
Uniform Bottom Size
Preferred Position
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent's Name
E-mail
example@example.com
Mobile Number
Format: (000) 000-0000.
Participant's Allergies
Participant's Medical Conditions
Name of Participant's Physician
Physician's Number
File Upload - Birth Certificate/State ID/Passport

Cancelof
File Upload- Participant Head Shot Picture

Cancelof
Refund Policy
Bylaws/Code of Conduct Agreement
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 (due November 30)-

7U COED(ages 5-7)- $250

9U COED(ages 8-9)- $300

11U Boys(ages 10-11)- $300

12U Girls(ages 9-12)- $300

Current Rosenberg Panthers Athlete Discount:

7U COED(ages 5-7)- $200

9U COED(ages 8-9)- $250

11U Boys(ages 10-11)- $250

12U Girls(ages 9-12)- $250

$25 Late Registration Fee included after November 30.

Football & Cheer participants are eligible for $50 discount!

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

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Payment Options

7U COED(ages 5-7)(PAY NOW)

$250.00 Quantity

**9U COED(ages 8-9) **11U Boys(ages 10-11) **12U Girls(ages 9-12)

$300.00 Quantity

Payment Plan(Deposit Required)

$25.00 Quantity

(PAY OFFLINE)

Free Quantity

Enter coupon

Subtotal

Tax

Total

Payment Methods

Credit Card

Apple Pay

Google Pay

Cash App Pay

ACH Bank Transfer

Afterpay

Should be Empty:

Winter 26-27 PYBA Registration

WAIVER OF LIABILITY RELEASE FORM

Payment Options*

Payment Methods

Payment Options