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In-House Registration

If you've already registered and just want to pay using PayPal, please click here.
If you have any problems registering online, please contact us.
Parent / Guardian
First Name: Last Name:
Street:
City: State: Zip:
Email: (enter as many as you like, separated by commas)
Home Phone: () -
Cell Phone: () -
Work Phone: () -
Child
First Name:Last Name: (remove child)
Date of birth: / / (MM/DD/YYYY)
Gender:
Grade:
Size:
Medical Concerns:
More kids? Click here to register another child
Injury Release

In consideration of membership in WYBA or participation in the activities and programs of the WYBA and to use its facilities, equipment, and machinery in addition to the payment of any fee or charge I do hereby waive release and forever discharge the: Mount Greylock Regional High School; Lanesboro Elementary School: Williamstown Elementary School, the Williamstown Youth Center, Williamstown Youth Basketball Association (WYBA), Lanesboro Recreation Committee and their officers, directors, agents, employees, representatives, executors, and all others from any and all responsibility or liability for injuries or damages resulting from my or my child's participation in any activities or use of equipment or machinery in the above-mentioned facilities or arising out of their participation in any activities at said facility. I do also hereby release and agree to indemnify all of those mentioned and any others acting upon their behalf from any responsibility or liability for any injury or damage to me or my child, including those caused by the negligent act or omission of any of those mentioned or others, acting on their behalf or in any way arising out of or connected with my participation in any activities of the WYBA or the use of any of the equipment at the WYBA. I agree to adhere to all policies set by the WYBA.

I have read and agree to the injury release

Medical Release

As a parent or guardian, I do hereby authorize the treatment by a qualified and licensed medical doctor of the previous minor in the event of a medical emergency which, in the opinion of the attending physician, may endanger their life, or cause disfigurement, physical impairment, or undue discomfort if delayed. The authority is granted only after a reasonable effort has been made to reach me. This release form is completed and signed of my own free will with the sole purpose of authorizing medical treatment under emergency circumstances in my absence.

I have read and agree to the medical release

Video and Audio Release

Indicate by clicking one of the statements below whether you consent to and authorize the use and reproduction of any and all photographs or video footage taken of your child for WYBA purposes. I understand that I receive no reimbursement for allowing his/her photograph to be taken or for the use of the photo or video.

I allow photographs or video of my child to be used
I DO NOT allow photographs or video of my child to be used