SWAC 2014-2015
WINTER REGISTRATION
Basketball – Fundamental/Squirt
Divisions
Date: ____/____/____
GENDER IDENTIFICATION
Last Name:
First Name:
Address:
Female
City:
Phone:
School:
Address Change
Zip Code: _____________
Grade:
Parent/Guardian: __________________________________
Registering for first time
Male
Birthdate: ___/___/___
Emergency Contact # _________________________
Email Address
(PLEASE PRINT)
SWAC is always in need of dedicated volunteers to continue serving the youth in our neighborhood. If you can help any
capacity with a sports team this season or are interested in joining the SWAC Board, please check one of the boxes below.
Coach or Co-Coach
SWAC Board
The Minneapolis Park and Recreation Board is committed to providing reasonable
accommodations and accessibility to all residents. Please check if you have specific needs
for participation and a staff will contact you personally. _______
Level
Grade*
Fundamentals-Open
Squirt - Open
*Squirt - GIRLS
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K/1
st
Birthdate*
Cost
Days of Games
9/1/07 - 9/1/09
$30
Friday Evenings (1/16-2/20)**
nd
2 /3
rd
9/1/05 - 9/1/07
$30
Saturday Mornings (1/17-2/21)**
nd
rd
9/1/05 - 9/1/07
$30
Saturday Mornings (1/17-2/21)**
2 /3
*PLEASE NOTE: If the Squirt Girls enrollment is low, we will merge with the Squirt Open teams to create a full league.
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** A weather related “make-up” date for Fundamentals is scheduled on Friday, February 27 and Squirts is Saturday, March 2
Shirts & equipment provided.
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Games & Practices will be at Lake Harriet School Gymnasium (Washburn Ave. Entry Doors – 49 & Washburn)
My child has permission to participate in the sports activity checked. I understand that my child plays at his/her own risk.
Parent/Guardian's Signature:
Special Requests (no guarantees):
Mail registration form to SWAC, P.O. Box 24438, Mpls, MN 55424-0438 with payment and a copy of birthdate
verification is REQUIRED if one has not been provided. (i.e - Birth Certificate, Passport, Medical or School Records)
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On-line registration is available at www.swac.info until November 17 .
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Beginning Tuesday, November 18 – register IN PERSON for:
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ALL Hockey & Wrestling at Linden Hills Park- 43 & Xerxes S (370-4913, [email protected])
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and ALL Basketball at Pershing Park – 48 & Beard S (370-4928, [email protected])
*During late registration space is based on availability, placement is not guaranteed and special requests cannot be accepted.
Scholarship Needed
Total Paid (see above)
***No refunds after the second game. Refunds will be mailed out after the season ends.***
CHECK #