Syracuse Select - Central New York's Premier Youth Basketball Program

SYRACUSE SELECT BASKETBALL TRYOUTS REGISTRATION

* REQUIRED FIELD
Boys Team Division:*
Under 11 Year Old Team Tryouts $30.00 Under 12 Year Old Team Tryouts $30.00 Under 13 Year Old Team Tryouts $30.00 Under 14 Year Old Team Tryouts $30.00 Under 15 Year Old Team Tryouts $30.00 Under 16 Year Old Team Tryouts $30.00 Under 17 Year Old Team Tryouts $30.00 Under 18 Year Old Team Tryouts $30.00

Player Information

Players Name First:* Last:*
Address Line 1:*
Address Line 2:
City:*
State:*
Zipcode:*
Phone:*
E-mail:*

Credit Card Information
Card Type:*
Card Number:*
Expiration:*
Card Verification Number:* CVV NUMBER IS A 3 OR 4-DIGIT NUMBER LOCATED ON BACK OF CARD

HEALTH AND BEHAVIOR GUIDELINES: I, the undersigned, submit my son is physically fit to participate in strenuous athletic activity and waive Syracuse Select, Inc. of any and all responsibility for injury or illness. I hereby authorize the directors of Syracuse Select to act for me according to their best judgment in any emergency requiring medical attention. I understand that I am solely responsible for the payment of any such medical expenses and must provide Syracuse Select with proof of medical and accident insurance. I also understand that my payments are non refundable and non transferable under any circumstances. I understand that anyone who does not abide by facility rules or regulations is subject to dismissal without refund or recourse: