LEARN
PLAY
GROW
WINTER YOUTH BASKETBALL
IRVIN DEUTSCHER FAMILY YMCA
YMCA Youth Basketball provides children with an introduction to the sport in the best possible
environment. The league introduces new skills, enhance preexisting abilities and teaches the
rules of the sport providing growth and development within the child. YMCA sports are about
teaching the fundamentals of the game, learning the values of sportsmanship, all while having
fun in the process.*
4 Divisions
Pee Wee Basketball: 3-5 years old
Rookie Basketball: 5-7 years old
Winners Basketball: 7-9 years old
Champions Basketball: 9-12 years old
When: Saturday and Sundays, February 7th, 2015 – March 29th, 2015
Where: Charlotte Wood Middle School • 600 El Capitan Drive, Danville, CA 94526
Program Fee
Facility Member: $125
Non-Member: $150
For more information, contact Sam Allen Director of Sports and Recreation at
(P) 925 887 4538 or [email protected].
Register online or call (P) 925 687 8900
*Financial assistance is available. This activity is not sponsored by the San Ramon Valley Unified School District. Approval for flyer distribution
does not imply endorsement, but is a courtesy service to the community.
Non-Profit Tax ID # 94-1156635
Name of Participant _____________________________________________________________________________________________________________
(Last)
(First)
Gender:
M F
Date of Birth:_____________
Grade:__________________________ School:__________________________________________________________________________________________
Parent/Guardian _______________________________________________________________________________________________________________
(Last)
(First)
Email:_______________________________________________________________________________________________________________________________
Home Address:____________________________________________________________________________________________________________________
City:_________________________________________________________State:________________Zip:____________________________________________
Phone:_______________________________________________________________________________________________________________________________
Emergency Contact:________________________________Relationship:________________Phone:_____________________________________
Session Name
Winter Basketball
Session Dates
2/7/15 – 3/29/15
Program Fee*
Amount Enclosed
Balance Due
$
Total:
*program fees are non-refundable and non-transferable. Registration fees are due in full at time of registration for most
programs.
 Pee Wee Basketball (ages 3-5)
 Rookie Basketball Baseball (ages 5-7)
 Winners Basketball (ages 7-9)
 Champions (ages 9-12)
Jersey Size
 youth small
 youth medium
 youth large
 adult small
I would be interested in volunteering as a(n):
 Coach
 Assistant Coach
 Team Parent
Name(s) of volunteer(s):______________________________ phone
 adult medium
 Referee/Official
Teammate / Coach Request ________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________
Method of Payment
o Check enclosed
o
Charge Credit Card
 MasterCard
Check # _______________
 Visa
Amount $ ________________
 Discover
 American Express
Account Number: ________________________________ Exp: ____/_____Name on Account: _____________________
Signature of Account holder: __________________________________________________________________________