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MID ATLANTIC SELECT CLUB REGISTRATION
Please complete the following club registration form for your child. Once you have completed the form please click the "Submit" at the and of the form and we will contact you with the date and time for you to bring your child for a try-out. Please choose the correct age division for your child based on the AAU Eligibility Rule as of September 1, 2009. For example: If your child is currently 11 years old and will turn 12 years old before September 1, 2009, he is considered for the 12U age division. * Required Fields - Please fill out all fields below
* Name:
* Address:
* City:
* State:
* Zip Code:
* Telephone #:
Email Address:
School:
HGT.:
GPA:
PSAT/SAT:
Health Insurance:
Policy #:
Basketball Experiance:
ElementaryJr. High Freshman Junior Varsity Varsity
Minutes/Game: Points/Game: Rebounds/Game:
AAU Age Group
9U
10U
11U
12U
13U
14U
15U
16U
17U