Tournament Registration

Renegades Basketball

Tournament Registration Form

Please use the form below to register and make payment per team by mail or credit card to:

Renegades Basketball - 858 Street Rd. - Southampton, PA 18966 Pay by credit card by clicking here!

Team Name

Click to Select Tournament
Basketball Team: Girls Boys

Street Address

Address 2

City

State

Zip Code

Coach Name

Cell Phone

Home Phone

Work Phone

Fax#

Contact Name

Cell Phone

Home Phone

Work Phone

Schedule Request

E-mail

Level:
National A B C

Age Group

School Grade

Are you staying overnight on these nights? (Please check) Friday Night Saturday Night

How many hours to gym if commuting?

Team Name
Click to Select Tournament
Basketball Team:	Girls Boys
Street Address
Address 2
City
State
Zip Code
*Coach Name*
Cell Phone
Home Phone
Work Phone
Fax#
*Contact Name*
Cell Phone
Home Phone
Work Phone
Schedule Request
E-mail