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HRA REGISTRATION FORM
To register your child, please provide the information below. After submitting your form, you will be redirected to the payment page to complete your transaction.
Which sport are you registering for?
*
Please select
Boys Basketball - K thru 1st
Boys Basketball - 2nd thru 4th
Boys Basketball - 5th thru 8th
Girls Basketball - K thru 1st
Girls Basketball - 2nd thru 4th
Girls Basketball - 5th thru 8th
Wrestling
Player Name
*
First
Last
Age
*
Grade
*
Please use numbers only (1, 2, 3 not 1st, 2nd, 3rd) - for Pre-K, use 0
Date of Birth
*
MM
/
DD
/
YYYY
Male/Female
Home Phone
*
###
-
###
-
####
Email
*
Can your coach email you about practices/games?
Yes
No, please call only.
Please add me to the Email Update list to receive sports info, deadline reminders, and other HRA updates!
*
YES
No thank you.
Already signed up!
Preferred Practice Days:
*
Mondays & Wednesdays
Tuesdays & Thursdays
Either
HRA will make best efforts to accomodate your preferred practice days request; however, CANNOT BE GUARANTEED as this depends on number of registrations received and coach availability.
Practice TIMES are at the discretion of the coach.
Please see the HRA FAQ page for more info.
Fathers Name
*
Father's Work Phone
###
-
###
-
####
Mothers Name
*
Mother's Work Phone
###
-
###
-
####
Mailing Address:
*
Emergency Contact Name (if parent/guardian unavailable) & Relationship to Child
*
Emergency Contact Phone
*
###
-
###
-
####
Do you authorize first aid treatment?
*
Please select:
Yes
No
Any special instructions?
I am willing to:
Please Select One:
Assistant Coach
Carpool
No thanks.
Coach
If ordering an HRA Jersey, please select size:
Please select:
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
OFFICE USE ONLY - YS
OFFICE USE ONLY - YM
OFFICE USE ONLY - YL
OFFICE USE ONLY - AS
OFFICE USE ONLY - AM
OFFICE USE ONLY - AL
(Additional $32)
I, and my child, have read and agree to HRAs Parents Code of Ethics and Player Conduct rules:
*
Yes
SCHOLARSHIPS
Have you received an APPROVED Scholarship?
No
Yes
Verify sport you have received approval for:
Please select
SCHOLARSHIP 2014 Basketball
SCHOLARSHIP 2014 Wrestling
Select sport you have received an APPROVED scholarship for
Scholarship Approval #
This number was provided to you in the email sent to you when your scholarship was approved.
FOR HRA OFFICE USE ONLY
OFFICE USE ONLY
Payment/Amt./Check#