WWW.RECBASKETBALL.COM
Individual Player Registration
Individual Players Personal Information:
Name:
Gender:
Male
Female
Age:
Address:
City:
State, Zip:
<Select>
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Guam
Puerto Rico
Armed Forces Americas (AA)
Armed Forces Outside Americas (AE)
Armed Forces Pacific (AP)
New Brunswick
Newfoundland
Alberta
Northwest Territories
Nova Scotia
Prince Edward Island
Quebec
Saskatchewan
Ontario
Yukon Territory
Manitoba
British Columbia
None
Phone #1:
Home
Work
Cell
Pager
Fax
Phone #2:
Home
Work
Cell
Pager
Fax
Email:
League Information:
League:
Sunday
Tuesday
Thursday
Other - ->
Skill Level:
A skill level
(most played college)
B skill level
(small college, very good HS players)
C skill level
(some high school players maybe not all)
D skill level
(most players did not play HS but are good players)
E skill level
(recreational players, coed teams)
Additional Notes/Comments:
Document Agreement:
I Agree
I have completed the the
Waiver/Release Form
.
Method of Payment:
In person at a gym
- You can give the money to a head referee on our league nights 7 days in advance of the event you are paying for. Our league nights are Sunday, Tuesday, + Thursday. When you go to pay in person, ask who is the head official, and pay him. Please put your payment in an envelope with your team name on it. To see what gyms we are at, got to www.RecBasketball.com, click on schedules and pick a gym near you.
By mail
- You can mail the payments (
we need to receive them 7 days before your event
) to:
RecBasketball.com
Mailbox #600
11124 NE Halsey
Portland, Oregon 97220
Credit Card Authorization
Season Paying for:
Discounts:
Amount Applying to the Card
If I am paying by credit card,
I,
authorize RecBasketball.com/Universal Whistles LLC to charge my credit card in the above amount to cover fees for basketball League(s) or Tournament. I realize that I am paying for the structure of a basketball league. I understand that satisfaction is not guaranteed. I am paying for a schedule and the normal workings of a league. If I am unhappy with the league, if I receive technical fouls, if I am ejected, or suspended, I realize that this is part of being in a league, and I understand that I have no right to refunds of any kind. For these reasons all charge backs will be invalid with my submission of this form.
Visa
MasterCard
Credit Card #
Name of the person on the CreditCard
Expiration Date
(09/09)
Verification Code:
You can find the 3 digit Verification Code on the back of your credit card somewhere near the Signature line. This 3 digit Verification Code number will follow the last four numbers of your 16 digit credit card number.
NOTICE: Only click the "Submit Form" Button Once.
It can take up to two minutes to process the form.
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