WBYA Membership Form

Email address *

Name *

Date of Birth *

Age *

Grade *

School *

T-Shirt Size *

Youth Sizes

Small Medium Large Extra Large

Parent / Guardians Names *

Address *

Contact Phone Number *

Are you interested in being a ball girl / boy *

Yes No

If you are interested in being a ball girl / boy, please choose three games below where you would be available

Please choose how you would like to make your payment *

There will be a $2 processing fee for online payments

Pay Online ($2 fee) Check

If you chose check option, you will still be asked to enter payment information on the next page but will not be charged.

If you chose to make your $10 payment by check, please make it payable to:

SVSU Women's Basketball
7400 Bay Rd.
University Center, MI 48710

* required field