2008-09 Civic Club Basketball Registration
DATE______________
Child’s Name__________________________________________
Phone Number_________________________________________
Grade__________
Sex____________
The Civic Club is looking for volunteers to help with the following:
Coaching___________
Asst. Coaching ______
Officiating _______
Time Keeper _______
Coach or Official’s Name ________________________
Phone number if Different________________________
The cost of this year’s program is
$30.00 per child for readiness, first grade, and second grade Boys and Girls.
$40.00 per child for 3rd– 8th grade Boys and Girls, and H.S. Girls.
$60.00 per child for H.S. Boys.
Maximum per family $100.00.
After Nov.11th, there will be a late sign up fee of an additional $10.00 per child.
The club reserves the right to suspend any participant for poor conduct.
If the cost of this program is a hardship, please notify any Civic Club member. The club will make sure that all
children are able participate.
The club reserves the right to suspend any participant for sustained poor conduct. Proof of Hampstead
residency is required.
The club reserves the right to suspend any participant for poor conduct.
Draft Day is Saturday November 15th.
Parent or Guardian Signature ___________________________________
For Club use only:
Paid______ Cash____ Check#_________Not Paid______
Should you have any questions, Please contact Dano Anderson @ 329-4844