EmailMe Form - ARIZONA BREAKERS NEW PLAYER INQUIRY

Athletes Name *

Prefix First Last Suffix

Parent(s) or Guardian Name *

Main Email *

We communicate all club information by email address for all announcements and scheduled events. If you do not have an email account, we will use text messaging as an alternate.

Confirm

Secondary Email

Primary Phone - Cell *

### - ### - ####

Secondary Phone - Cell or Home

### - ### - ####

Home / Mailing Address *

Street Address City State / Province / Region Postal / Zip Code Country

Athlete Gender *

Girls may play in boys divisions, but boys cannot play in girls division.

Grade *

Athlete Date of Birth *

MM / DD / YYYY

Date of Birth as of Oct. 1st determines age division.

Athlete's Current School Attending *

Athlete's Primary Sport *

Has Athlete ever played Club Basketball? *

Is Athlete a current AAU Member? *

Athlete Expereince Level? *

Club Basketball will sometimes require out of town/state travel. How often would you be able to attend scheduled non-local events? *

All Scheduled

Some Scheduled

Not Interested in out of Town Travel

Will define in message text below

Are there any dates you cannot participate in/with club activities?

MM / DD / YYYY

Message *