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Print & fill-out your registration packet below.
Registration Packet

Bring The following items to the field:

Birth Certificate

Proof of Residency

Record of Physical

Online Pay Receipt

 

 
Pebblebrook Basketball Registration

Students Information

First Name:    Last Name:  

Address:

City:     State    Zip:

Birth date:  //
School of Attendance:
Team:  6th  7th   8th
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1st Parent's or Guardian's Information
Parent #1 Name:  

Parent #1 Phone:  

Parent #1 Emergency Phone:  
Parent #1 Email:  
Parent #1 Occupation:  

2nd Parent's or Guardian's Information
Parent #2 Name:  

Parent #2 Phone:  

Parent #2 Emergency Phone:  
Parent #2 Email:
Parent #2 Occupation:
______________________________________

Registration & Equipment Deposit
Fall Basketball online?    $150.00     
 
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We can now Register Online!!!
You can now register online,  by clicking the "Submit" button below.  A  $10.00 convenience fee will be add to your total to pay online.