Joplin Youth Basketball

Student Information

Student's Date of Birth(Required)

Student's Gender(Required)

Student's Current Grade(Required)

The grade your child will be in during the upcoming basketball season.

What school does your child attend?(Required)

Name of School

If you selected "Other" please tell us which school they attend.

Student's Height(Required)

Student's Weight(Required)

Special Team Member Request

NOTE: Not all requests can be honored.

If you do have a sibling or family member playing for JYBA, please provide their first and last name.

Shooting Shirt Size(Required)

Jersey Size(Required)

Pant Size(Required)

Years of Experience

If they have played before, was if competitive or recreational?

Parent/Guardian Information

Parent/Guardian Phone(Required)

Parent/Guardian Email(Required)

Emergency Contact Information

Emergency Contact 1 Phone(Required)

Emergency Contact 1 Email(Required)

Emergency Contact 2 Phone(Required)

Emergency Contact 2 Email(Required)

Student's Medical Conditions & Allergies(Required)

If your child doesn't have any notable medical conditions or allergies, please type "None" into the input field.

Your Name (Coach)

Your Email (Coach)

Your Phone (Coach)

Your Name (Manager)

Your Email (Manager)

Your Phone (Manager)

Your Name (Sponsor)

Your Email (Sponsor)

Your Phone (Sponsor)

Donations

Joplin Youth Basketball Association is a volunteer-based 501-3c organization the relies on the generosity of our community to help support and fund the league, giving these children an opportunity to build lasting friendships and develop skills that will foster growth and development beyond the basketball court. If you would like to make a contribution, please enter an amount into the box below.

Donation Amount

Please enter an amount you would like to donate to JYBA.

Parent/Guardian Consent Information

Permission Release(Required)

My child, specified above, has permission to be a player for the Joplin Youth Basketball Association program. I understand that they must abide by the rules and guidelines set forth by the Joplin Youth Basketball Association's “Rules and Guidelines” (visit the link directly above this). I have read and understood that the violation of any of these rules may lead to temporary or permanent suspension from the program. Parent initials are required.

Physical Injury Release(Required)

I understand by the very nature of the activity, players carry a risk of physical injury. No matter how careful the player and coaches are, the risk cannot be fully eliminated. I understand these risks and will not hold any of the Joplin Youth Basketball Association personnel or participants responsible in the case of accident or injury at any time. Parent Initials are required.

Media Consent Options(Required)

Media Consent Release(Required)

Parent/Guardian Signature(Required)

By signing, I submit that the above information is accurate and complete and that I agree and consent to the rules and conditions set forth by the Joplin Youth Basketball Association.

If so, please contact us at joplinyouthbasketball@gmail.com for more information. Be sure to click the "Save & Continue" button below to save your progress and visit the link it provides you to finish completing your application and enter the coupon code we provide to you.

Coupon

If you requested financial assistance, please enter the coupon code we provided to you here.

Registration Fee

Price:

Total

Please be aware that applications are not considered complete until payments have been submitted and received.

Instagram

This field is for validation purposes and should be left unchanged.