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ATHLETE REGISTRATION

Complete in full.

Player Jersey Number

First Name

Last Name

Player Phone Number

Player Height

Player Weight (lbs)

Grade Year

High School

High School Address

City

Province

Postal Code

Country

High School Coach Name

High School Coach Phone

EYBL Team Director Name

EYBL Team Director Phone

Player Home Address

Apartment, suite, etc

City

Province

Postal Code

Country

Player Email Address *

Player Date of Birth

Twitter Handle

Player Instagram

Uniform Size

Track Suit Size

Shoe Size

International Player

Emergency Contact Name

Emergency Contact Phone

Emergency Contact Email

Insurance Carrier

Insurance Policy #

Name of Insured (Policy Owner - Not player)

Date of Birth of Insured (Policy Owner – Not Player)

UPLAY CANADA

We Assist in Your Academic and Athletic Development.

Contact Us

admin@uplaycanada.com
@uplaycanada
@uplayca
@uplaycanada

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