Registration

Fields marked with an * are required.

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Player's First Name

Player's Last Name

Parents Names

Both Parent's First Name

Parent's Email Address

Player's Email Address

Player's Birthdate

Parent's Cell Phone #

Format Example: 123-456-7890
(Use a hyphen between the numbers, PLEASE use this format)

Player's Cell Phone #

Format Example: 123-456-7890
(Use a hyphen between the numbers, PLEASE use this format). DO NOT FILL THIS OUT IF THE PLAYER DOES NOT HAVE A CELL PHONE! DO NOT PUT THE OTHER PARENTS NUMBER HERE.

Address

Street Address

City

Country

Use Proper punctuation please. Fill out all fields and capitalize the the Street Name, etc above. (Example: 1234 Street Name)

Weight

Format Example: 185
(Only put the number)

Current School Name

Current BCPBL Team

Payment

Discount

Subtotal

Tax

Total USD