Basketball Registration

* indicates a required answer.

1. *

Students Name: (a registration form must be filled out for each student)

2. *

Parents Name and Home Address:

3. *

Home Phone Number:

4.

Cell Phone Number:

5. *

Email is required.

6.

Additional Email or email address for student if different from parents:

7.

Indicate male or female:

Male Female
8.

Students Grade:


Use your Ctrl & Shift keys to select multiples.
9.*

Students Current Age:

10. *

Students Date of Birth (mm/dd/year):

11. *

Height:

12. *

Weight:

13.*

Students Uniform jersey size:

14.*

This registration form covers both the girls and boys developmental and interscholastic programs.  Please indicate below whether your student is registering for the girls or boys teams and which Eagles basketball program your student is registering for:
 

15.*

Students Uniform shorts size:

16.

How did you hear about the James River Eagles?

17.*

Would you consider your basketball skills to be: (choose one)

18.*

I certify that my child is home-educated and that we have read and agree to abide by the James River Home School Foundation's Player and Parent Code of Conduct.

I also give JRHSF permission to use photographs taken of my child throughout the season to be used in publications related to the James River Eagles and the James River Home School Foundation, Inc.

 (1 required)
I accept
19.*

You MUST provide a copy of the students birth certificate if it has not already been provided AND a copy of the current Virginia Notice of Intent to Home School Form or a copy of your religious exemption waiver.
Please send a copy of both documents in with your payment or indicate if previously submitted:
1) Students birth certificate, and
2) Notice of Intent OR Religious Exemption

 (1 required)
Copy of birth certificate previously submitted. Copy of birth certificate will be provided.
Copy of religious exemption on file.

James River Eagles - Interscholastic Basketball
Registration Prices:

5th & 6th Grade Developmental Girls Team.....$150.00
Middle School Girls..........................................$200.00
High School Girls.............................................$250.00

5th & 6th Grade Developmental Boys Team.....$150.00
Middle School Boys..........................................$200.00
High School Boys.............................................$325.00

We offer a 10% Sibling Discount for each player within a family!

Checks can be made payable to:

 James River Eagles
 
and mailed to:
James River Home School Foundation
3374 Medway Lane
Powhatan, Va 23139


 

Don't forget to provide a copy of your current Virginia Notice of Intent Form or religious exemption and a copy of your child's birth certificate (unless already on file) with your payment.

Also please complete and sign the Required Medical Information and Release of Liability form and return it with your paperwork.