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Richmond Hill Registration Form

Ages: 11-13

PLEASE NOTE!

Anyone who is put on the waitlist will be notified and refunded.

Please check the box if you are a returning student to make it easier for registration.

Thank you and we look forward to seeing all of you in September!

Student Information

Student First Name:

Student Last Name:

Address:

Birth Date: (M-D-Y)

Shirt Size

Student Email

Student Phone Number

Other: Are there any allergies or other medical condition(s) that we should be aware of ?

Parent/Guardian Information

Parent 1 First Name:

Parent 1 Last Name:

Address:

Phone Number

Parent 2 First Name:

Parent 2 Last Name:

Adddress:

Contact Email

Contact Phone Number

Emergency Contact

First Name:

Last Name:

Relationship

Contact Phone Number

Sign-Up Options

Age 11 - 13 ( T-Shirt Included) - C$158.00

Age 11 - 13 + Extra T-Shirt - C$180.00

Age 11 - 13 + $25 Donation - C$183.00

Age 11 - 13 + $50 Donation - C$208.00

Age 11 - 13 + $100 Donation - C$258.00

Age 11 - 13 + Extra T-shirt / $25 Donation - C$205

Age 11 - 13 + Extra T-shirt / $50 Donation - C$230.00

Age 11 - 13 + Extra T-shirt / $100 Donation - C$280.00

Age 11 - 13 + Hoodie - C$207.00

Age 11 - 13 + Hoodie / $25 Donation - C$232.00

Age 11 - 13 + Hoodie / $50 Donation - C$257.00

Age 11 - 13 + Hoodie / $100 Donation - C$307.00

Total Includes:
$149.99 Dance Fee
1 T- Shirt Included
$8.01 Processing Fee

*I Understand that there are NO refunds. All sales are final .*

Your Signature

Please send me info on the PanMessinian Basketball Program.

I acknowledge that I have read the consent and waiver terms as well as the conditions and Policy procedures.View terms of use

Returning Student from 2025/2026

I give permission for my/my child’s photograph (s) and/or video recording(s) to be submitted in newspapers, social media and promotional literature.

Thanks for submitting!

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