COUGARS BASKETBALL PLAYER REGISTRATION FORM
PLAYER’S NAME ____________________________________________________
DATE OF BIRTH __________________________
GRADE ENTERING IN SEPT. __________
DIVISION _____________________________________
TEE SHIRT SIZE (CIRCLE)
YOUTH
S
M
L
XL
ADULT
S
M
L
XL
ADDRESS _____________________________________________________________________________
HOME PHONE ___________________________________________
EMAIL _______________________________________________________
PARENT(S)/GUARDIAN(S) NAMES ___________________________________________________
EMERGENCY CONTACT NAME ______________________________________________________
EMERGENCY CONTACT PHONE NUMBER _____________________________________________
MEDICAL CONCERNS (WHICH I SHOULD BE AWARE OF)
PHOTO PERMISSION: I hereby give permission for my child’s photograph to be used for the Woolwich
Cougars FACEBOOK page. _____________________________________________ (signature)
To reserve the player’s spot, please return the registration form (one per player) and FULL PAYMENT
(cheque payable to WOOLWICH COUGARS BASKETBALL). Payment by cheque OR E-transfer.
Paul McGinley, Program Director
Woolwich Cougars Basketball
115 Pine Valley Drive
Kitchener, ON N2P 2V8
Thanks,
Paul McGinley