2015 Individual Spring Basketball League
(League held at Pekin Eastern Community Schools)




Player Entry Fee: $65.00 (Guaranteed 7 Games)
Registration Deadline: March 30, 2015
Games Played on Sundays, starting April 12, 2015
Game Dates: Apr. 12, 19, 26, May 3
Divisions:
Elementary Boys 2-3 (Boys currently in Grades 2-3)
Elementary Boys 4-5 (Boys currently in Grades 4-5)
Elementary Girls 3-5 (Girls currently in Grades 3-5)
Middle School Boys 6-8 (Boys currently in Grades 6-8)
Middle School Girls 6-8 (Girls currently in Grades 6-8)
High School Varsity Boys (Boys currently in Grade 9-12)
High School Varsity Girls (Girls currently in Grades 9-12)
Additional Info:
 The first three (3) weeks players will play two games - followed by a single
elimination tourney on May 3, 2015
 We will place 7-9 kids on a team for ample playing time for each
participant. A minimum of 4 teams with 7 kids on a team will be needed to
offer a division.
 3 players from the same school can request to be on the same league team.
 Each player will receive a t-shirt to be worn as their game jersey.
 Spectators will be charged $4 for admission. 5 years and under is free.
For more information contact: Mitchell Speedy (502) 415-6943 – [email protected] or
Chuck Hensley (812) 797-4024 – [email protected]
Player Registration Information:
Players Name: __________________________ D.O.B: ___/___/_______
Address: ____________________________________________________
City: _____________________ State: ________________ Zip: _________
Home Phone: (____)____________ Cell Phone : (____)_______________
Parents Name: _______________________________________________
Email Address: _______________________________________________
Gender: (Circle) M F Height: _____ Weight: _____ Position: G F C
Division: (Circle) 2nd/3rd
4th/5th
3rd-5th (Girls)
MS 6th/7th/8th HS 9th-12th
School: ________________________Current Grade 2014/2015: ________
Shirt Size: (Circle)
YM
YL
AS
Parent Interested In Coaching? (Circle)
AM
Yes
AL
AXL
AXXL
No
Make Checks Payable To:
Mail Registration To:
Midwest Youth Tournaments
Midwest Youth Tournaments
3416 Morgan Trail
Jeffersonville, IN 47130
I, the above signed, hereby authorize any first aid, medication, medical treatment or surgery deemed necessary in case of an
emergency for the above player. I, the above signed, in consideration of the participation in Midwest Youth Tournaments
league, intending to be legally bound, do hereby ourselves, executors, and administrators waive, release, and forever discharge
any and all rights and claims for damages, including any claims for loss, damages or injury to our persons or property arising out
of the above player’s performance or failure of performance from the Midwest Youth Tournaments, their agents,
representatives, successors and assigns. I understand that the player I represent is responsible for proof of insurance coverage.
(Must be signed for player participation)
Print Name: ___________________________Signature: ______________________________________ Date: ___________