Section 1.

Player Information
  Please provide the following regarding the player:

First Name:

Last Name:

Home Phone #:

Parents Cell Phone:

Players Cell Phone:

Address:

City:

State:

Zip Code:

Height: Please select one;5' 15' 25' 35' 45' 55' 65' 75' 85' 95' 105' 116' 06' 16' 26' 36' 46' 56' 66' 76' 86' 96' 107' 07' 17' 2

Class & Year of High School Graduation: Please select one:2019202020212022202320242025other

Name of School:

GPA:

Shoe:

DOB:

Ethnicity (For Statistical purposes only) Select one:American Indian or Alaska NativeAsiaBlack or African AmericanNative Hawaiian and Other Pacific Islander WhiteHispanic or LatinoOther

Have you participated in IEBP’s Spring League in prior years?  If so, when?

Do you currently play for a Club/Travel Basketball Team? If yes, what team?

Would you be interested in participating in College Admissions, Financial Aid or SAT Workshops during the Spring League?

Do you have a friend, sibling or specific team that you would like to play with during the Spring League? (Please note that providing a preference does not guarantee team assignment.)

On what level did you play basketball during 2017/18?Please select one :VarsityJunior VarsityFreshmanMiddle School/Junior High

Uniform Size: Please Select One :MLXLXXLXXXL

Section 2.

Parent's Information
  Please provide the following regarding parent(s).  You may indicate n/a if only entering parental information for one parent:

Father's First Name:

Father's Last Name:

Mother's First Name:

Mother's Last name:

Home Phone:

Email:

Section 3.

Spring League 2019 Release
  Please provide the following regarding parent(s).  You may indicate n/a if only entering parental information for one parent:

The following is to be read and completed by a parent or guardian of the player named below.  Registration will be considered incomplete and players will not be allowed to participate if this section of the registration is not complete.

 I, the undersigned guardian/parent of (enter child’s name), freely give consent for my child to participate in the 19th Annual Spring Developmental League 2019 sponsored by the Inland Empire Superstar Foundation (IESF) & the Inland Empire Basketball Program (IEBP.  I understand that the above mentioned entities retain the rights to use photographs or statistical information of participants. 

 I agree to hold harmless, release, and disclaim any form of liability against Inland Empire Superstar Foundation, Inland Empire Basketball Program, coaches, Toyota, Adidas, and other corporate donors from indemnification for any accidents and/or injuries that my child sustains while the child participates, in route to or from participation, in or activities connected to, the 19th Annual Spring Developmental League.  The privacy of this disclaimer shall not be given or delegated to any person or personnel of any entity, except Inland Empire Superstar Foundation, without the written permission from the parent, unless a medical, contractual or legal duty arises.

Superstar Foundation the authority and permission to allow medical providers to provide necessary medical attention to my injured child when the injury occurs in the 19th Annual Spring League.

Medical Insurance Co: 

Policy#:

Physician's Name:

Telephone Number:

Parent/Guardian Name:

Date:

By typing your name in this box, you are signing and agreeing to the release as printed.  Parent/Guardian Signature:

Please indicate method of payment:
Please select one: :Online PaymentWill Pay by Money Order On-Site on March 1stMailing Payment to IEBP Other