Player & Parent/Guardian Information | Summer Basketball 2024 | Greater Melbourne Police Athletic League

First Name:*

Middle Name:

Last Name:*

Date of Birth - Ages 7-17 as of June 8, 2024:*

Race:*

American Indian or Alaska Native

Asian

Black/African American (Not of Hispanic Origin)

Hispanic or Latino

Native Hawaiian or Other Pacific Islander

White (Not of Hispanic Origin)

Two or More Races

Unknown Race or Ethnicity

I choose not to respond

Gender:*

Male

Female

Unspecified

Non-binary

School:*

Grade:*

Address:*

Address 2:

City:*

State / Province:*

Zip / Postal Code:*

Country:*

Team Name or Coaches Name if Known:

Parent/Guardian First Name:*

Parent/Guardian Last Name:*

Parent/Guardian Cell Phone:*

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Parent/Guardian Home Phone:*

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Parent/Guardian Email:*

Parent/Guardian 2 First Name:

Parent/Guardian 2 Last Name:

Parent/Guardian 2 Cell Phone:

Format XXX-XXX-XXXX

Parent/Guardian 2 Home Phone:

Format XXX-XXX-XXXX

Parent/Guardian 2 Email: