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Boys & Girls Club of Geneva

Empowering young people in our community to reach their full potential.

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Geneva Community Center

Youth Basketball Registration Form

Player's Name*
First Middle Last
Grade*
Birthday*
Date Format: MM slash DD slash YYYY
Sex*
- M
- F
Ethnicity
Ongoing health concerns?
Does your child have any ongoing health concerns? (i.e. asthma, diabetes, allergies, etc.)
Player's Shirt Size*
- Child Sm
- Child Med
- Child Lg
- Adult Sm
- Adult Med
- Adult Lg
- Adult XL
Child Count*
- One Child
- Two Children
- Three Children
Total
$0.00
2nd Player's Name*
First Middle Last
2nd Player's Grade*
2nd Player's Birthday*
Date Format: MM slash DD slash YYYY
2nd Player's Sex*
- M
- F
2nd Player's Ethnicity
2nd Player: Ongoing health concerns?
Does your child have any ongoing health concerns? (i.e. asthma, diabetes, allergies, etc.)
2nd Player's Shirt Size*
- Child Sm
- Child Med
- Child Lg
- Adult Sm
- Adult Med
- Adult Lg
- Adult XL
3rd Player's Name*
First Middle Last
3rd Player's Grade*
3rd Player's Birthday*
Date Format: MM slash DD slash YYYY
3rd Player's Sex*
- M
- F
3rd Player's Ethnicity
3rd Player: Ongoing health concerns?
Does your child have any ongoing health concerns? (i.e. asthma, diabetes, allergies, etc.)
3rd Player's Shirt Size*
- Child Sm
- Child Med
- Child Lg
- Adult Sm
- Adult Med
- Adult Lg
- Adult XL
Parent/Guardian Name*
First Last
Parent/Guardian Email*
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Emergency contact other than parent/guardian*
First Last
Emergency contact phone number other than parent/guardian*
I hereby certify that my child is in normal health and is physically capable of participating in the Youth Basketball League. I hereby release the Boys & Girls Club of Geneva, its instructors and the City of Geneva from any responsibility in case of an accident, damage, loss, or liability which may arise because of participation in this program. I understand that should this activity result in injury, it is my obligation to use my own resources in treatment of the injury.
Signature of Parent or Guardian*
- I agree to the above terms.
Volunteer
IF YOU ARE INTERESTED IN COACHING/VOLUNTEERING PLEASE INDICATE. *It is MANDATORY for all volunteers to complete a Volunteer Application and Background Check Form. (THERE WILL BE NO EXCEPTIONS)
- I would like to participate in the program
Volunteer Capacity*
I would like to participate in the program in one of the following capacities:
- Coach
- Assistant Coach
- Official
- Other
Volunteer Other Capacity*
Volunteer Name*
First Last
Volunteer Phone*
Volunteer Email*
Captcha
Phone
This field is for validation purposes and should be left unchanged.

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Mailing Address

160 Carter Road, Geneva, NY 14456

Goodman Street Club House

1 Goodman Street, Geneva, NY 14456
Phone: (315) 781-2345
Fax: (315) 789-2047
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Teen Center at the
Geneva Community Center

160 Carter Road, Geneva, NY 14456
Phone: (315) 759-6060
Fax: 759-6065
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