• This form must be completed in its entirety. 

• All 4 Sections must be complete or registration may be rejected.  

• Registration is not complete until you click Submit at the bottom of this page and pay the appropriate registration amount.

 

Section 1.

Player Information

  Please provide the following regarding the player:

First Name
Last Name
Street Address
Address (cont.)
City
State
Zip/Postal Code
County	Select One San Bernardino Riverside Los Angeles Orange Other
Cell Phone Number
Home Phone Number
E-mail

Name of School
Year of High School Graduation	Please select one: 2009 2010 2011 2012 2013
GPA
Height	Please select one: 5 1 5 2 5 3 5 4 5 5 5 6 5 7 5 8 5 9 5 10 5 11 6 0 6 1 6 2 6 3 6 4 6 5 6 6 6 7 6 8 6 9 6 10 7 0 7 1 7 2
Weight
Ethnicity (For statistical purposes only)	Select One American Indian or Alaska Native Asian Black or African American Native Hawaiian and Other Pacific Islander White Hispanic or Latino Other

Have you participated in IEBP’s Spring League in prior years?  If so, when?

 

Do you currently play for a Club/Travel Basketball Team? If yes, what team?

 

Would you be interested in participating in College Admissions, Financial Aid or SAT Workshops during the Spring League?

 

Do you have a friend, sibling or specific team that you would like to play with during the Spring League? (Please note that providing a preference does not guarantee team assignment.)

 

On what level did you play basketball during 2008/09?

            Please select one: Varsity Junior Varsity Freshman Middle School/Junior High Did not play in 2005/06

 

Uniform Size:

  Please select one: M L XL XXL XXXL

Section 2.

Parent's Information

Please provide the following regarding parent(s).  You may indicate n/a if only entering parental information for one parent:

Father's First Name
Father's Last Name
Mother's First Name
Mother's Last name
Home Phone
Cell Phone
E-mail

Section 3.

Spring League 2009 Release

The following is to be read and completed by a parent or guardian of the player named below.  Registration will be considered incomplete and players will not be allowed to participate if this section of the registration is not complete.

 I, the undersigned guardian/parent of (enter child’s name),     freely give consent for my child to participate in the 9th Annual Spring Developmental League 2009 sponsored by the Inland Empire Superstar Foundation (IESF) & the Inland Empire Basketball Program (IEBP.  I understand that the above mentioned entities retain the rights to use photographs or statistical information of participants. 

 I agree to hold harmless, release, and disclaim any form of liability against Inland Empire Superstar Foundation, Inland Empire Basketball Program, coaches, Toyota, adidas, and other corporate donors from indemnification for any accidents and/or injuries that my child sustains while the child participates, in route to or from participation, in or activities connected to, the 8th Annual Spring Developmental League.  The privacy of this disclaimer shall not be given or delegated to any person or personnel of any entity, except Inland Empire Superstar Foundation, without the written permission from the parent, unless a medical, contractual or legal duty arises.

 I give the representative(s) of Inland Empire Basketball Program, Inland Empire Superstar Foundation the authority and permission to allow medical providers to provide necessary medical attention to my injured child when the injury occurs in the 8th Annual Spring League.

Medical Insurance Co:    

Policy#:   

 Physician's Name:         

Telephone Number:      

 Parent/Guardian Name:              

 Date:01/23/2010

By typing your name in this box, you are signing and agreeing to the release as printed.  Parent/Guardian Signature: 

                                        

 

Section 4.

Spring League Payment

The registration is as follows:

On-line Pre-Registration	Through March 6, 2010	125.00
Mail in Registration	Through March 6, 2010	125.00
On-line Late Registration	After March 6, 2010	135.00
On-site Late Registration	After March 6, 2010	135.00

Please note the following:

1. Registration by mail will not be accepted after March 1, 2010 (registration must be received by IEBP by the 1st).

2. Spring League Registration is a 2 step process. 

   a.  You must first complete this registration form.

   b.   You must visit PayPal to pay your registration, or mail to Inland Empire Basketball Program.  As long as this Registration Form is completed on-line, players are eligible to pay the discounted on-line registration amount (according to the date of registration) as shown above -- even if the payment is mailed separately to IEBP.  However, payment must also be received by the appropriate date.

You may pay your registration online or;

you may complete this registration form, click the Submit Button below and then mail the appropriate amount to:

    Inland Empire Basketball Program

    3410 La Sierra Avenue

     Box # F-213

     Riverside, CA 92503

 

Please indicate method of payment:

  Please select one: Online payment Will Pay by Money Order On-Site on March 6th Mailing Payment to IEBP Other

 

Payment Amount:

  Please select one: $125.00 Online Pre-registration $125.00 Mailing In Payment Before 3.1.10 $135.00 -- Late Registration Online $135.00 Paying Late Registration On Site Other (Please send details to iebp@aol.com)

If you are paying on-site on Saturday, please remember to pay with a money order payable to The Inland Empire Basketball Program.  Checks will NOT be accepted.

Please e-mail any questions or issues to iebp@aol.com.  Staff will respond within 24 hours.

 

You may print your registration form for your records prior to submission.

After successful submission, you will be directed to the PayPal website to make your payment.

 

Please do not complete the registration form multiple times.   If you are unsure as to whether your registration was received successfully after your first attempt or if you need to make corrections after submission, please e-mail iebp@aol.com.

Thank you for registering for the 2010 Spring League!!  We look forward to seeing you!!