Arizona Lutheran Academy

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Arizona Lutheran Academy 2021 Basketball League

Boys and Girls in grades 6-8
Instructional league with games and practices under the supervision of the ALA basketball coaches. All players receive a practice jersey.

COST
$75 per athlete

DATES
January 16, January 23, January 30, February 13, February 20

PLACE
Arizona Lutheran Academy
6036 S 27th Ave, Phoenix

STAFF
Benjy Wells – Varsity girls basketball coach
Wells@ALAcoyotes.org

Jade St. Germaine –JV girls basketball coach
Stgermaine@ALAcoyotes.org

Doug Meyer – Varsity boys basketball coach
Meyer@ALAcoyotes.org

Mish Aleisa – JV boys basketball coach
Aleisa@ALAcoyotes.org

CONTACT INFORMATION
Doug Meyer
Phone: 602-268-8686 x 15
Email: Meyer@ALAcoyotes.org

Qty

Description

Amount

Total

Registration

$75.00

---

per athlete

Total: $0.00

Registration Information

Child's Name:

School:

Grade (2020-2021):

Age:

Shirt Size:

Parent Information

Parent Name: *

Address: *

City: *

State: *

Zip Code: *

Parent’s Phone (home): *

Parent’s Phone (work/cell): *

Medical Information

Insurance Company: *

Insured’s Name: *

Policy Number: *

Please note any medical conditions or allergies:

Parent/Guardian Permission:
Above said child(ren) has my permission to participate in the ALA 2021 Basketball League. I hereby take all responsibility concerning my child's physical condition upon entering the camp. I also authorize the camp leaders to seek emergency medical attention for my child if needed.

Parent/Guardian Permission: *

Check here to indicate that you have read, understand and agree to the terms of the Parent/Guardian Permission agreement above.

Payer Information

First Name: *

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *