Player Name * First Name Last Name Gender * BOY GIRL GRADE * 1st 2nd 3rd 4th 5th 6th JERSEY SIZE * Please specify whether youth or adult size PARent/guardian Name * First Name Last Name Phone (###) ### #### Email METHOD OF Payment * Registration fee: $40 per player online payment, Venmo, or check only Online Payment Portal is Below Registration Form Venmo: @Ten30-Basketball Check: Payable to 1030 Basketball Mail Check To: 1030 Basketball 1059 Madison 207 Fredericktown, MO 63645 ONLINE VENMO CHECK Thank you! $40.00 Player Registration 3% Cover the Fee PAY NOW PAY NOW