Step 1: Basketball Registration Information

PLEASE COMPLETE ALL FIELDS BELOW
You may sign up one (1) child at a time.

Child Information ( must be filled out completely)*
Name:	* DOB: *
Sex:	Male Female
Street Address:	* Zip: *
School:	* (required)
Grade:	* (required)
League:	Recreational Team
Parent / Guardian Information ( required)*
Father's Name:	* Cell #:
Mother's Name:	* Cell #:
Family Email:	*
Home Phone:	*
Would either parent like to volunteer as head coach?	Yes No Maybe
Coach's email:
Will your company sponsor a team for $350?	Yes No If yes, how many? (we will contact you at a later date for payment)
Additional comments or requests:
How did you find out about KYS?	Personal Referral Outdoor Signage Search Engine (Google, Yahoo, Bing, etc.) Email Newsletter Direct Mail Other
Liability Statement ( required)*
I hereby give my permission in the above athletic program and hereby release and hold harmless Knox Youth Sports, Inc., and its officers, directors, employees, agents, and coaches from and against any liability incurred in connection with or arising out of my child's participation in the said athletic programs. I understand that only sibling team requests will be guaranteed.
	Yes, I agree.*
	PLEASE NOTE: Your registration will not be processed until payment is received in Step 2.