Upwards Sports Registration

This Form is for late registrations, and an alternative way to make card payments.

Name

*

Sport

*

Please select one option.

Basketball Cheer

DOB

*

Grade

*

Parent Name

*

Gender

Please select one option.

Male Female

Parent Email

*

This address will receive a confirmation email

Phone

*

Sizes

*

Please select one option.

Youth XS Youth S Youth M Youth L Youth XL Adult M Adult Large Adult XL Adult XXL

If Paying for more than one child, please list their name here

Payment

Pay In Person ($0) One Child ($150) Two Children (280) Three Children (390) Early Bird on child ($125) Early Bird Two Children ($230) Early Bird Three ($315)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

This Form is for late registrations, and an alternative way to make card payments.

Please Fix the Following

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