Eastside Basketball Association

EASTSIDE
BASKETBALL ASSOCIATION

Eastside Basketball Depends on Sponsor Donations. Please Visit our Sponsor Pages Below. (You may find money saving coupons!!!)

EBA 2008 CO-ED SUMMER LEAGUE
8 Saturdays (6/14, 6/21, 6/28, 7/5, 7/12, 7/19, 7/26 and 8/2)
Perinton Community Center (PCC - 1350 Turk Hill Road)
-- League Times --
Age 7-8 --> 4:00 - 5:20 PM
Age 9-10 --> 5:20 - 6:40 PM
Age 11-13 --> 6:40 - 8:00 PM
-- Registration Fee $50 --

FILL OUT INFORMATION BELOW PRINTOUT AND MAIL WITH CHECK TO:
KEVIN LEGG // 871 MACEDON CENTER ROAD // FAIRPORT, NY 14450
Make checks payable to Eastside Basketball Association.
YOUR CANCELLED CHECK WILL BE PROOF OF ENROLLMENT
For additional info phone Kevin Legg at 585.425.1883
(Please complete ALL information below.)

(as of September 2008)	GRADE: DOB: AGE:
MOTHER'S NAME:
PHONE NUMBER:

FATHER'S NAME:
PHONE NUMBER:
	(Please include complete address information.)
ADDRESS:
E-MAIL ADDRESS:

DOCTOR:
PHONE NUMBER:

EMERGENCY CONTACT:
PHONE NUMBER:

SPECIAL CONDITIONS:

I hereby give permission for my child
to participate in the EASTSIDE BASKETBALL PROGRAM. I understand and agree that I am responsible for insurance coverage and neither the Eastside Basketball Program, Supervisors, or the associated facility may be held liable for any injury to my child while participating in the program.

SIGNATURE: ________________________________ DATE:

Kevin Legg - klegg@esbasketball.com or 585-425-1883

Eastside Basketball Association

EASTSIDE BASKETBALL ASSOCIATION
871 Macedon Center Rd., Fairport, New York 14450
Fax 585-421-9025 - Phone 585-425-1883
E-Mail klegg@esbasketball.com
E-Mail comments to: webmaster@esbasketball.com