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Use tab to navigate through the menu items.

Player Information:

Player First Name

Player Email

Player Last Name

Player Phone

Address

Current Grade

What School Do You Attend?

Birthday

Gender

Male

Female

Parent Information:

Dad Full Name

Dad Email

Dad Phone

Mom Full Name

Mom Email

Mom Phone

Emergency Contact:

Emergency Contact 1

Emergency Contact 2

Emergency Contact 1 Phone

Emergency Contact 2 Phone

Medical Information:

Does Player Have Any Medical Conditions? If so, What?

Does Player Have Any Allergies?

Is the Player on any Medications? If So, What?

Who Is Your Insurance Carrier? Please Provide Policy Number.

Who Is the Primary Physician and Phone Number?

I authorize NoVA United 1 to seek medical treatment for my child in the event of an emergency.

Yes

No

Uniforms

Player Desired Number

What is the Requested Size of Jersey?

Adult X Small

Adult Small

Adult Medium

Adult Large

Adult X Large

Adult XX Large

What is the Requested Size of Shorts?

Adult X Small

Adult Small

Adult Medium

Adult Large

Adult X Large

Adult XX Large

T-Shirt Size?

Adult X Small

Adult Small

Adult Medium

Adult Large

Adult X Large

Adult XX Large

Size of Shoes (Wish List)

I confirm all information above is true and accurate. I also confirm that I have received and read the NoVA United 1 Waiver and Disclosure and agree with the information contained therein.

Waiver | NoVA United (novaunitedbasketball.org)

Parent Signature

Required Documentation

Please upload a copy of each item below:

(These items will be needed for national tournament verification)

Copy of Birth Certificate

Upload File 1

Upload supported file (Max 15MB)

Welcome to the NoVA United Family!

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