2014
Senior League
Current Grade

9th
10th
11th

The 2013 Billy Lake Memorial Girls Basketball League

Senior League

P.O. Box 536
Havertown, PA 19083
(Complete Application, Print, Sign & Mail)
Name:

Phone:

Address:

Email:

City:

School:

State:
 Zip:

Height: Position:

2014 Billy Lake Senior League Fee:
$75.00

This year's 23rd Billy Lake ALS Marathon will be played on a date to be determined. If you would like to make a donation to the marathon, just add the donation to the application. All donations are tax deductible and all proceeds benefit ALS (Lou Gehrig's disease) Research.

 

Yes, I would like to make a donation to help ALS Research:

Total:

Make Checks Payable To: The Billy Lake Memorial League

Note: Applications will not be accepted if the form is not complete, player quota is reached in your division, Registration Fee is not included, and the Player/Parent signature is missing. All players who participated last year are reinstated if the application is received by February 28,2014.

Waiver

We acknowledge that the above information is true and that any falsification will result in dismissal from the league without refund. We acknowledge that the Township of Upper Darby , the School District of Upper Darby , the Billy Lake League, its Directors and Referees are not responsible for any physical injury that occurs during a sanctioned game. It is the responsibility of the players and parents to maintain adequate medical insurance. We waive and hold harmless the above mentioned for any damages or injuries that may occur during a sanctioned game.

Player Signature:

___________________________________________
  

Parent Signature:

___________________________________________
 Date:____________