Green Ridge Girls League Player's Name*Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Cell PhoneShirt Size*Youth SmallYouth MediumYouth LargeAdult SmallAdult MediumAdult LargeAdult Extra LargeAdult XXLAge*Grade*Kindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th GradeBirth Date* HeightFeet*Inches*Email* SchoolDivisionA (6th-8th Grade)B (4th-5th Grade)C (2nd-3rd Grade)D (K-1st Grade)Coach I'm willing to be a coach Coach's Name*Cost* Price: $65.00 Team SponsorshipI'm willing to sponsor a team ($100)Sponsor NameEnter another child?YesNoSecond ChildPlayer's Name*Shirt Size*Youth SmallYouth MediumYouth LargeAdult SmallAdult MediumAdult LargeAdult Extra LargeAdult XXLAge*Grade*Kindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th GradeBirth Date* HeightFeet*Inches*Email SchoolDivisionA (6th-8th Grade)B (4th-5th Grade)C (2nd-3rd Grade)D (K-1st Grade)Coach I'm willing to be a coach Coach's Name*Cost* Price: $60.00 Team SponsorshipI'm willing to sponsor a team ($100)Sponsor NameEnter another child?YesNoThird ChildPlayer's Name*Shirt Size*Youth SmallYouth MediumYouth LargeAdult SmallAdult MediumAdult LargeAdult Extra LargeAdult XXLAge*Grade*Kindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th GradeBirth Date* HeightFeet*Inches*Email SchoolDivisionA (6th-8th Grade)B (4th-5th Grade)C (2nd-3rd Grade)D (K-1st Grade)Coach I'm willing to be a coach Coach's Name*Cost* Price: $55.00 Team SponsorshipI'm willing to sponsor a team ($100)Sponsor NameComments and Total CostCommentsConsent* I / we are in good physical health and capable of participating in strenuous physical activity, and waive Excel at Backcourt Hoops of any and all responsibilities for injury or illness. I hereby authorize the staff at Excel at Backcourt Hoops to act for me according to their best judgment in any emergency requiring medical attention. I understand that I am solely responsible for the payment of any such medical expenses. I also understand that my payments are non-refundable, non-transferable under any circumstances. Green Ridge Girls League Total $0.00 Payment Method*Credit CardCheckCredit card payments will be processed securely via QuickBook Payments. We do not store or save any credit card data on the Backcourt Hoops website. Billing Address is the Same as Address above Billing Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20182019202020212022202320242025202620272028202920302031203220332034203520362037 Expiration Date Security Code Cardholder Name CAPTCHAPhoneThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.
