Parent/Guardian Name *

First Name

Last Name

Parent/Guardian Phone Number *

(###)

###

####

Other Parent/Guardian Phone Number *

(###)

###

####

Athlete's Name *

First Name

Last Name

Athlete's Date of Birth *

MM

DD

YYYY

Athlete's Jersey Size *

Youth XS

Youth Small

Youth Medium

Youth Large

Youth XL

Adult Small

Adult Medium

Adult Large

I Have Read and Agree with the Acacia Hoops Forms Linked Directly Below this Registration: *

YES

Attending Basketball Clinics? *

YES

NO

Attending Preschool-2nd Grade Skill Sessions?

Yes

No