Player Registration — Silverback Basketball

1

Parent / Guardian

Who we contact about schedules, placements and anything that comes up at practice.

Full name *

Relationship to player *

Mobile phone *

Email *

Street address

City *

ZIP *

Best way to reach you *

Second parent / guardian (optional)

Full name

Relationship

Mobile phone

Email

2

Players

Registering siblings? Add each child — we'll place every player separately.

Player 1

First name *

Last name *

Goes by

Date of birth *

Plays in *

Grade this fall *

School

Jersey / shirt size *

Approx. height

Shooting hand

Previous team or league

Preferred jersey #

Basketball experience *

Dribbling

Shooting

Passing

Defense

Position preference

Season goals

In a new group, my child is…

Teammate request

We'll try, but placement isn't guaranteed.

Health & learning (private)

Shared only with administrators and your child's assigned coach.

Allergies

Medical conditions coaches should know

Medication needed at practice

Carries

Learning needs, injuries, or helpful coaching tips

3

Emergency & Pickup

Who we call if we can't reach you, and who may pick up your child.

Emergency contact name *

Relationship *

Phone *

Other adults authorized for pickup

Pediatrician / doctor

Doctor phone

Health insurance provider (optional)

Emergency and pickup details are visible only to Silverback administrators and your child's assigned coach.

4

Schedule & Family

Helps us plan practices. Final schedules will be shared once set.

Days your family can usually make practice

I'd be interested in helping as…

How did you hear about Silverback?

5

Agreements

Please read and agree to each item separately.

Participation & liability

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I agree *

Emergency medical treatment

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I agree *

Code of conduct

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I agree *

Photo & video permission *

Yes — public team photos and videoPrivate team group onlyDo not share my child's image

Parent / guardian signature (type full name) *

Date *