Open Tryout Registration

SELECT TRYOUT SESSION*

10/3 SESSION 1 MORNING 8-11 AM 10/3 SESSION 2 AFTERNOON 1-4 PM

Personal & Employment Data

Name*

First Name

Initial

Last Name

Email*

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Cell Phone*

Are you at least 18 years of age?*

Yes No

Age*

As of 10/3/21

Do you currently have a legal right to work in the US?*

Yes No

Will you now or in the future require sponsorship for employment visa status?*

Yes No

Do you have any restrictions that would prohibit you from traveling outside of the United States?*

Yes No

If yes to above, please explain (location(s), nature of restriction)

What mode of transportation will you be utilizing for your travel?*

Flying Train Driving Local Transit

Check all that apply

COVID-19 Vaccine Type*

Johnson & Johnson Moderna Pfizer

Date of First Vaccination Dose*

Date of Second Vaccination Dose*

If Johnson & Johnson (one dose), write "J&J"

PLAYING EXPERIENCE

Height*

Weight*

High School Playing Experience?*

Yes No

Name of High School

High School Location

If yes, what years did you play high school basketball?

College Playing Experience?*

Yes No

Name of College/University

College/University Location

Did you graduate college/university?

Yes No Not Applicable

If yes, what years did you play college basketball?

Did you play professional basketball?*

Yes No

If yes, what years and what teams?

Can you provide a coaching reference?*

Yes No

If yes, please provide the coach’s name and contact information below.

Player Signature*

[clear]

Use your mouse or finger to draw your signature above

In addition to the above online registration form and credit card payment, Please be sure to complete the following forms in their entirety. Please note all registration material, including proof of COVID-19 vaccination, must be completed by Thursday, September 30 at 5:00 pm ET:

- Player Release & Eligibility Form (completed and signed) - download below

- Medical Consent and Authorization Form (completed and signed) - download below

- $200 Registration Fee in form of credit card payment (cash/checks can be taken at door)

- Copy of front and back of COVID-19 Vaccination Card

Player Release & Eligibility Form (Click to download)
Medical Consent and Authorization Form (Click to download)

Credit Card Number*

Credit Card Expiration*

MM/YY

Credit Card CVC #*

FRONT - COVID-19 VACCINATION CARD UPLOAD*

No File Chosen

File uploads may not work on some mobile devices.

Front of Vaccination Card

BACK - COVID-19 VACCINATION CARD UPLOAD *

No File Chosen

File uploads may not work on some mobile devices.

Back of Vaccination Card

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