Summer League Player Registration Form

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					                                                EDMONTON BASKETBALL ASSOCIATION                                                                              DUE:                JUNE 27, 2012

                                                  PLAYER REGISTRATION FORM
                                                      (PLEASE PRINT NEATLY WITH ALL INFORMATION COMPLETE)
                                                                                                                                                             MEN      □          WOMEN □
                            TEAM NAME: ______________________________________________________________
 EBA                                                        Jersey
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           NAME (FIRST, LAST)                               number             ADDRESS & POSTAL CODE                            AGE      PHONE #                           EMAIL

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FREEDOM OF INFORMAITON AND PROTECTION OF PRIVACY ACT: Personal information collected from you is collected under the authority of S.32c of the Freedom of Information Protection of
Privacy Act and will be used to administer program registrations, membership management and facility bookings for Community Services. Aggregate data will be used for program planning and evaluation.
Questions about the collection of personal information should be directed to the Community Services FOIP information should be directed to the Community Services FOIP Co-ordinator at 496-4863.

TEAM REPRESENTATIVE SIGNATURE: _________________________________________________________                                                            DATE SIGNED: __________________

				
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