Hoops for Kids Registration Form : Sponsor Events : Get Involved : Boys & Girls Clubs of Metro Louisiana

Registration fee is $20 per team. Please note that all team names must be unique across divisions to avoid confusion, i.e., if you are registering more than one team, please be sure that each has a different name.

Payment Amount

Team Fee ($20)

First Name

Last Name

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Team Name

Coach

School

Phone

Please select one: GIRLS OR BOYS?

Please select one: GRADES 4-6/GRADES 7-8/GRADES 9-12

Player 1

First Name

Last Name

Player 1 Email

Player 1 Grade

Player 2

First Name

Last Name

Player 2 Email

Player 2 Grade

Player 3

First Name

Last Name

Player 3 Email

Player 3 Grade

Player 4

Player 4 Email

Player 4 Grade

Select a Payment Method

Credit Card
Bank Account

Cardholder Name

Credit Card #

Expiration Date

Security Code

Billing Zip Code

Cover the fee associated with this online transaction?

Yes, I will pay an additional {transaction_fee} to cover the cost of this transaction.

Cover the fee associated with this online transaction?

Account Holder

First Name

Last Name

Account Type

Checking
Savings

Account Number

Routing Number

Make this a monthly payment?

Yes, bill my card today and on the 16th of every following month.

Make this a monthly payment?

Your total payment will be

Your credit balance will cover

Your credit card will be charged

Your bank account will be charged

Accident Waiver Form

Please have all parents/guardians of participants read the above document and check the box below.

By checking this box, I am certifying that I have read the above document, and I fully understand its contents. I am aware that this is a release and indemnification of liability for myself and my child, and I sign it of my own free will.

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Hoops for Kids Registration Form

Boys & Girls Clubs of Metro Louisiana Administrative Office

Boys & Girls Clubs of Metro Louisiana Oscar J. Tolmas Regional Service Center

Boys & Girls Clubs of Metro Louisiana Administrative Office

Boys & Girls Clubs of Metro Louisiana Oscar J. Tolmas Regional Service Center