Riverside Youth Basketball League

Registration Form 2019-2020

Players Name: ________________________________ Age: _________ Grade:____________

Address:______________________________________________________________________

Birthday:__________________ Sex: __________ School:______________________________

Mother/guardian Name:_______________________________ cell: _____________________

Father/guardian Name:________________________________ cell:______________________

Best email address: ____________________________________________________________

Jersey Size: Youth XS S M L XL Adult S M L XL

Shorts Size: Youth XS S M L XL Adult S M L XL

Are you interested in coaching: YES NO

If yes, Name:_____________________________________ Cell:__________________________

Coach preference for your child: ______________________________________

Registration Fee: $60.00 first child $40.00 for additional siblings

Please make checks payable to RYBL or pay with cash or card

Paid with: Cash Check #_______ Card Received By:___________________

_________________________
Wavier of Liability

I, ______________________________ (parent/guardian), am aware of the nature of this sport

and I assume responsibility of ___________________________ (player) to participate. I will not
hold the Riverside Youth Basketball League responsible in the case of an accident or injury as a
result of participation.

Signature ________________________________________ Date_____________________

Email completed form to jebowles@yahoo.com or mail to 19 Cross Creek Drive Belle WV 25015

Not endorsed by KCS Call/text 304-552-9753 with questions No Refund