WH Youth Basketball Registration

PLEASE SEE THE PROGRAM DETAIL SHEET FOR FULL PROGRAM INFORMATION BEFORE REGISTERING YOUR PARTICIPANTS.

You may register up to four participants with a single submission of this form.

IMPORTANT:
- Registration is not completed until payment in full has been received. You will be directed to the online payment page after submitting this registration form.

- If you have already submitted this form but not yet paid the fee, do not submit the form again. You can go directly to the online payment page here.
  • Parent / Guardian Information

  • Enter name of parent or guardian completing this registration.
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  • Emergency Contact Information

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  • Participant Information

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  • 2nd Participant's Information

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  • 3rd Participant's Information

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  • 4th Participant's Information

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  • Misc. Information

  • Enter the medical or physical concerns here. If you have registered more than one participant, be sure to indicate which one the concern pertains to.
  • If you have any additional information you'd like to provide, enter it here. (this field is not required)
  • Insurance Information

    NOTICE REGARDING INSURANCE: There is no accident coverage provided with this program. Therefore it is required that you agree to one of the following in order for you or those being registered to participate.
  • LIABILITY WAIVER

    A liability waiver and hold harmless agreement must be agreed to in order for those being registered to participate. Please CLICK HERE TO READ THE DOCUMENT. (opens in a new window)
  • I have read and fully understand and agree to the PARTICIPANT LIABILITY WAIVER AND HOLD HARMLESS AGREEMENT. I indicate this agreement by entering my full name in the AGREEMENT field, and today's date in the AGREEMENT DATE field.
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    Enter today's date please.
  • SUBMIT REGISTRATION

    Please check your information, then click the SUBMIT button below. You will be directed to the payment page. Registration is not complete until payment has been made.
    If you have any questions please contact the Recreation Department at (847) 746-3505.