Team Name________________________________ Jersey Color: __________________________

Head Coach_______________________________  Age Division: ___________________________               

Phone: ______________________  Cell: ____________________ E-mail: ____________________

Assistant Coach: _________________________________________________________________   

Players name                                            Position                  Birthdate                   Jersey size/number

1.   _________________________           _____                  ___________                   ______/______

2.   _________________________           _____                  ___________                   ______/______

3.   _________________________           _____                  ___________                   ______/______

4.   _________________________           _____                  ___________                   ______/______

5.   _________________________           _____                  ___________                   ______/______

6.   _________________________           _____                  ___________                   ______/______

7.   _________________________           _____                  ___________                   ______/______

8.   _________________________           _____                  ___________                  ______/_______

9.   _________________________           _____                  ___________                   ______/______

10. _________________________           _____                  ___________                   ______/______

11. _________________________           _____                  ___________                   ______/______

12. _________________________           _____                  ___________                   ______/______

CENTRAL ARIZONA BASKETBALL ORGANIZATION

Individual Registration form-fax: 602-953-2874

FALL SEASON 2009- 9-18-09 thru 11-14-09-(13, 15, 16, 17's &18's-U  Divisions) Eight  week season with one week of Play-offs included. Player fee: $120.00. Please mail this form with check payable to:

 C.A.B.O. 

4757 E. GREENWAY RD. STE 107B- PMB 276 PHOENIX, ARIZONA 85032

            Players' Name: _____________________________Address: ________________________

            Phone: ___________________________________City, State ZIP: ______________

            Email: ______________________________

            Parents Names: _________________________

            Players' Age: ____________________ Players DOB: ______/______/______

            Players' Height: _________________ Players’ Weight: _________________

            Health Problems: _____________________________________________________

            Players' Position: __________School Attending: ___________________________

            Requested Coach: _________________________Requested Team: ____________

            Adult Shirt Size: ____                                      Requested jersey number__________

            Parents Signature: ____________________________________

            NOTE: It is the responsibility of the Parent/Legal Guardian, to sign this form. If it is not signed, C.A.B.O. will NOT take responsibility should a minor be injured while on our premises.

      FEE$___________CHECK#______________

       LATE FEE ($25.00) ___________________

       TAX DEDUCTIBLE DONATION_________ TOTAL___________________