Team league form

Indiana Basketball Academy League Registration Form

Team Fee is $495 and payment is due prior to your first game.

Team Name:_____________________________________Grade Level:____________________

Contact Name:____________________Contact Phone:_____________ (cell/work)_____________

Contact Address: _______________________________________________________________

City_________________________________ State__________________ Zip______________

Email Address___________________________@_________________________

Coach's Name (if different from Contact person) __________________________________________

Coach's daytime phone ______________________ Coach's email __________________@__________

	Name (last, first)	Address (street, city, state, zip code)	Home Phone
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