Gibson Youth Basketball League Form
* required field.
Student:
Student's last name: *
Student's first name: *
Select gender: Male Female *
Age: *
Enter birthdate: Month 1 2 3 4 5 6 7 8 9 10 11 12 Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 *
School name: *
Grade: Select grade 4th 5th 6th 7th 8th 9th
T-Shirt size: Select size Youth S Youth M Youth L Youth XL Small Medium Large X-Large XX-Large *
Address: *
City: *
ZIP/Postal code (only numbers, no dashes or parentheses): *
Parent/Guardian 1 Contact Information:
Name: *
Parent/Guardian 1 Home Number (only numbers, no dashes or parentheses): *
Parent/Guardian 1 Cell Number (only numbers, no dashes or parentheses): *
Parent/Guardian 1 Email Address: *
Parent/Guardian 2 Contact Information:
Parent/Guardian 2 Home Number (only numbers, no dashes or parentheses): *
Parent/Guardian 2 Cell Number (only numbers, no dashes or parentheses): *
Parent/Guardian 2 Email Address: *
Emergency Contact Information:
Phone Number (only numbers, no dashes or parentheses): *
If you were given a code from HNB, please enter it here:
Please only click 'Submit' once! This process can take over a minute. You will be redirected to PayPal to pay for the cost of the league ($40 + processing fee).