Parent/Guardian Information

Full Name:

Mailing Address:

E-mail Address:

Primary Phone Number:
Alternate Phone Number:

Participant's Information

First and Last Name:

Participant's Grade in School:

Participant's Gender: Male Female

School Participant is Attending:

Activities

Select the activity in which you would like your child to participate

Iddy Biddy Ballers ($60.00) Select Season Winter Spring Summer Fall          

Tiny Tots ($60.00): Select Season Winter Spring Summer Fall          

Pee Wee Hoops ($60.00): Select Season Winter Spring Summer Fall         

*Soccer Tots Select Season Winter Spring Summer Fall ($60.00):

*not offered this session

Personal Basketball Training: Please contact for Appointment

Basketball Camps when offered are only for half-days (9am to 12pm).    ($75.00)                                                                          

Columbia Orange Basketball Program:   TBA                                               

Please contact us regarding Columbia Orange membership

Questionnaire

T-Shirt Size: Select Size YS (6-8) YM (10-12) YL (14-16) YXL (18-20) Small Medium Large XL XXL

Is your child currently under a physician's care or on medication?
Yes No

If yes, explain:

Are you a parent interested in volunteering/coaching?
Yes No

Did you or your child coach or play in MSC's Leagues last season?
Yes No

Please type in which day you prefer to participate: Saturday or Sunday

Additional information:

Signature

Parent/Legal Guardian Signature: Date:
Typing your name in the above field constitutes a digital signature.

Please note that NO Refunds. MSC will credit participants for another activity if a situation prohibits them from participation.