Morinville Youth Basketball Association
2017-18 Registration
Player’s Information:
Player’s Name:
_____________________________________________________
 Female  Male
Date of Birth:
_____________________________________________________
Age: __________
Home Address:
________________________________________________________________________
Municipality:
_______________________________________
Alberta Health Care #:
________________________________________________________________________
Medical Concerns:
________________________________________________________________________
Postal Code: __________________
________________________________________________________________________
Parent(s) / Guardian(s) Information:
Parent/Guardian Name:
________________________________________________________________________
Relationship to Player:
________________________________
Email Address:
________________________________________________________________________
Parent/Guardian Name:
________________________________________________________________________
Relationship to Player:
________________________________
Email Address:
________________________________________________________________________
Cell #: ______________________________
Cell #: ______________________________
Emergency Contact Information (if different than parent/guardian):
Emergency Contact:
________________________________________________________________________
Relationship to Player:
________________________________________________________________________
Cell Phone Number:
________________________________________________________________________
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Player’s Name:
_______________________________________________________________________________
I, the parent/guardian of the above registered player, do release and forever discharge Morinville Youth Basketball
Association (MYBA) and Edmonton Youth Basketball Association (EYBA) from any and all claims and demands
whatsoever against MYBA and/or EYBA.
I, the parent/guardian of the above registered player, further agree and understand that the coaches, directors,
managers, coordinators and their members of MYBA and/or EYBA shall not be held responsible for any liability,
injury, or accident during, or traveling to and from games and/or practices. Without limiting the generality of the
foregoing, I acknowledge that basketball is a physical game and that injuries may occur.
I, the parent/guardian of the above registered player, further grant permission to MYBA & EYBA to use all personal
information (including picture images) gathered for the purpose of MYBA and EYBA including, but not limited to,
reporting to governing bodies/agencies and for use in advertising and promotional material.
Parent’s/Guardian’s Signature:
__________________________________
Date:
_____________________
Parent’s/Guardian’s Name:
_________________________________________________________________
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Player’s Name:
_______________________________________________________________________________
MYBA requires that three separate cheques be submitted with each registration. All cheques shall be made
payable to: Morinville Youth Basketball Association
1.
$100.00 Uniform Deposit Cheque, dated March 1, 2018 (cheque will be destroyed if the player’s uniform
is returned to MYBA within 2 weeks of the final game or practice)
2.
$100.00 Volunteer Fee Cheque, dated March 1, 2018 (cheque will be destroyed at the end of the season if
the parent/guardian has met their volunteer requirements – see volunteers section below)
3.
MYBA Registration Fee Cheque, dated September 1, 2017. The amount of this cheque shall be determined
based on the following breakdown:
A. Registration fee:
B.
i.
Mite (born 2009 or later)
See next page
ii.
Mini (born 2007-2008)
$240
iii.
Bantam (born 2005-2006)
$295
iv.
Midget (born (2003-2004)
$295
v.
Juvenile (born 2000-2002)
See next page
Parental credit carried forward from previous season (fundraisers, donations, etc.) – contact
MYBA to determine the current value of your parental credit.
_______________ - _______________ = _______________________
A
B
TOTAL REGISTRATION FEE
(CHEQUE #3 VALUE)
Volunteers
MYBA is an organization which relies on parent/guardian volunteers. Please indicate your preference of volunteer
areas below (your preferences are not guaranteed, and all volunteer assignments will be determined by MYBA):
 Coach
 Assistant Coach
 Team Manager
 Time/Score Keeper
 Gym Patrol
I do not wish to volunteer, please deposit (cash) my $100.00 Volunteer Fee Cheque. Initialed: ________
If I am asked to volunteer and I am unable to complete my volunteer requirements, I understand, agree, and
consent that MYBA will deposit (cash) my $100.00 Volunteer Fee Cheque. Initialed: ________
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Mite registration fee & deposits:
The registration fee for the Mites program is $150. No volunteer or uniform deposit cheques are required
for the Mites. Each Mite player will receive a t-shirt to keep, with their name and a number on the back,
which will be used for any games that are played.
Juvenile registration fee & deposits:
The registration fee for the Juveniles program depends on whether the coach anticipates having enough
players to field a team for the fall season only (approximately 10 games, ending in mid-November), or
both the fall and winter seasons (ending in March). Please assume a registration fee of $200, which will
cover the fall season only.
Once the roster is finalized, if the coach expects to be able to field a team for the winter season as well,
then an additional fee of $95 will be required for each player on the team. Players who have paid for the
fall and winter seasons ($295) but who are unable to play the winter season due to playing for their high
school team (or due to the team disbanding as a result of losing more high school players than the coach
anticipated) will receive a refund of $95 for the winter season within 45 days of the end of the fall season.
Volunteer and uniform deposit cheques for the Juvenile teams are required as per the previous page.
Submission of Registrations and Cheques:
All registrants shall mail their completed registration forms and all required cheques to:
Morinville Youth Basketball Association
9514 – 96 Street
Morinville, AB T8R 1H8
or contact James Bedford at 780-217-3717 or [email protected] if you wish to make other
arrangements (dropping off the forms and cheques, payment by cash or e-transfer).
Payments and registration forms will no longer be collected by coaches.
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