CYAP Little League Basketball
2013 -2014 Community Youth Activities Program Basketball Season
Eligible players: Kindergarten - Sixth Grade Boys & Girls
Fill out forms; mail these pages as soon as possible with payment to cyap address info below or
go online at communityyouthactivitiesprogram.org
Athlete Name:
(last name, first name)
Parent Name:
(last name, first name)
Street Address:
Email Address:
City:
State:
Home Phone:
zip code:
Cell Phone:
Emergency contact during the day:
phone:
Enrolled School:
Grade (K – 6th Grades), Fall 2013:
Male/ Female:
Check / Yth jersey size S
Age:
M
L
Date Of Birth:
XL
or/
Adult jersey size M
Send application and money to:
CYAP
P.O. Box 534
Purcell, OK 73080
L
XL
Make checks payable to:
CYAP
Checks returned for insufficient funds will be assessed an
additional $10 service charge
Questions: gskoontz@yahoo.com
Registration - Same Family Household
Post marked before 11-18-13
(Each child after 3 add $50.00)
Post marked after Nov 18, 2013
(Each child after 3 add $60.00)
No Refunds
1st Child
$60.00
2 Children
$105.00
3 Children
$150.00
$70.00
$130.00
$190.00
CYAP Little League Basketball
Please Print — you must also complete this form.
Unity Basketball D
I/we hereby release Purcell Public Schools, Community Youth Activities Program Inc,
Directors & volunteers from all claims on account of any injuries/illnesses which may be
sustained by my/our son/daughter while attending Basketball activities. If any emergency
requiring medical attention is required, I authorize the volunteers to act in my behalf.
Parent/Guardian:
Signature: _________________________________________________
Print Name: ________________________________________________
Contact phone #(s) during season: __________________________________________
Print Athletes Name(s): ___________________________________________
Date: _________________________________________
Emergency Contact Person (if unable to reach the
Parent/Guardian listed above):
Name: ____________________________________________
Phone: ____________________________________________
Needed: Please circle if applicable, role(s) you may like to volunteer for the CYAP basketball
season.
Head Coach
Assistant Coach Registered OSAA Official
Gym commissioner Volunteer
Fill out forms; mail these pages as soon as possible with payment to:
CYAP, P.O. Box 534, Purcell, OK 73080
*Checks returned for insufficient funds will be assessed an additional $10 service charge*
AM'T. _______________ CK. # _________________ REC’D. BY _________________ DATE __________________
CYAP Little League Basketball
SIGN UPS ARE HERE!!
2013-2014 CYAP Basketball Season
General Information: Keep page for your records.
Eligible Athletes:

K thru 6th grade boys / girls from community & nearby communities



Registration fee is $60.00 per athlete participate*
Late Fee – If post marked after November 18th is an additional $10.00
Sign-ups online or at the Multi Purpose Center on following days in
October: Tuesdays – 6:00pm – 8:00pm, Saturdays – 9:00am –
12:00pm. November 5th, 12th – 6:00pm – 8:00pm, November 2rd, 9th,
16th – 9:00 – 12:00.


www.communityyouthactivitiesprogram.org
No Refunds.




Saturdays, January 4th thru March 1rd, 2014
Schedules TBA - depending on number of teams participating
Junior High School Gym & Intermediate School Gym – Purcell, OK
Doors open at 7:30am & close promptly 30 minutes after last game


CYAP area that includes neighboring communities:
Participants will become better fundamental basketball players thru
basketball instruction, games, and training. In addition, to continue to
learn great sportsmanship for boys and girls grades K thru 6th.
Practices are TBA starting in December 2013, participants will be
contacted by a CYAP coach from registration contact information.
Fees and
Registration:
Games:
When & Where:

Season Includes:
Equipment
players need:
Misc: Help
wanted for
upcoming
season:
Mission
Statement:


appropriate clean gym sneakers, shorts, t-shirt , & socks
(No Jewelry & Hats please)
Head Coaches
Assistant Coaches Registered OSAA Officials
Volunteers
To promote and provide the youth of our community with a safe
environment and encourage positive life choices through education,
recreation, and community service activities.
Questions: www.communityyouthactivitiesprogram.org – or gskoontz@yahoo.com
Proceeds to benefit the mission of Community Youth Activities Program