Registration for Blythe's Basketball AAU Program

Please complete the registration form below. Required fields are marked with *. The fee for the 2014 season is $1,200 and includes the instruction and opportunities outlined here. Registrations are not valid until payment is completed. You may pay online via PayPal or offline via check/money order. Your payment options are available from the confirmation page.

Athlete/Parent Information

First Name*

  Last Name*

Address*

City*

 ,  State*

Zip*

Gender*

Male     Female 

Birthdate*

  , 

Height*

 in.    Weight* lbs.

Parent Name: 
(if athlete is under 18) 

Contact Information

Home Phone*

Cell Phone: 

e-Mail*

(a confirmation of this registration will be sent to the e-mail address above)

Additional Athlete Information

AAU Membership #: 

School Team Name: 

School Name: 

School City: 

Grade: 

Current Coach's Name: 
(if any) 

Coach's Phone: 

Coach's e-Mail: 

Club Experience: 

List details of the player's experience including age/grade groups, leagues (AAU, NJB, CYO, other) and out-of-area tournaments the player attended.

School Basketball Experience: 

List details of the player's experience including team/grade groups.

Goals for Improvement: 

Comments: 

 

Referred By: 

     

I the Parent / Guardian authorize my child to participate in skill development work-outs. (If applicable)

     


SUBMIT
Please SUBMIT the form and continue to confirmation page.


















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