ACADIANA BIDDY BASKETBALL                                    2007-2008

       __________Girls         __________Boys   (Please indicate)

 

161 Vincent Road  Lafayette, La.  70508       ph (337-856-2763)      fax(337-857-0499)

______________________________www.acadianastars.com______________________

 

REGISTRATION:                    Age Group: ___5/6’s___7/8’s___9/10’s

                                                   How old were you on  Sept. 1^st, 2007_____

                                                                                Age_______DOB_______                            

Name:________________________________________________________

 

Address:______________________________________________

 

City______________LA  Zip________Home Phone__________

 

Parent’s Names:_______________________________________

 

Parent’s #’s: Mom’s wk:__________Mom’s cell/pgr._________

                       Dad’s wk:___________Dad’s cell/pgr.__________

School Attending______________________________Grade___

 

Email address(s) _______________________________________

                            ________________________________________

(email addresses are VERY IMPORTANT.  Most  communication throughout the season is done thru email , therefore if you have more than one address you would like to supply, please do so.)

 

Are you already covered by health & accident insurance?

                      _________yes__________no

T-shirt size: youth__________adult___________

 

For Boys only—please indicate preference of location to practice_____North ____South

 

For office use only____________________________________Date paid_________

                                                                           Amount paid________

                                                                             Check#______________