Please print out the application and bring it to Registration.

Or you may fill out the application and submit it from this Web Site after payment.
You will need a payment receipt number in order to submit a registration form.

:: Click on the button below to make the Payment $280.00 ::

Age Group

9 and Under 10 and Under 11 and Under 12 and Under 13 and Under 14 and Under

Player's Name

Player Information:
League * 9 and Under 10 and Under 11 and Under 12 and Under 13 and Under 14 and Under 15 and Under 16 and Under 17 and Under	Did your child play for the Celtics last year?  Yes No
Date of Birth mm/dd/ccyy *	Age        Height        Weight
First Name *	M.         Last Name  *
Address	City State Zip AK AL AR AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY
Years of Celtics Participation	School
Player's Uniform Size * Adult Small Adult Medium Adult Large Adult XLarge Adult XXLarge Adult XXXLargeYouth Medium Youth Large Youth XLarge	Shoe Size
Physicians Name	Physician Phone
Insurance Company	Policy #
Physical Restrictions/Disabilities
Parent Information:
Mother's Name *	Fathers's Name
Home Phone	Home Phone (if different)
Work Phone	Work Phone
Cell Phone	Cell Phone
Email address	Email address
Parent Registration Agreement:
Receipt Number * (with dashes)
There is a $280 donation to participate in the Atlanta Celtics’ Spring and Summer Basketball Program. This fee includes: Use a game uniform Social Awareness Experiences Basketball Skill Development AAU State Tournment One Additional Tournment End of Season Banquet Donation is due at the time of registration. All donations must be received before any of the above items or services can be provided. No refund once shoes, and/or uniforms are worn. All players will be eligible for participation on the travel teams, but all selections are at the coach’s discretion. Parent/Guardian signature agrees to indemnify and hold harmless the Atlanta Celtics, Inc., its Board of Directors, Sponsors, Facility Owners and/or operators from claims, demands and judgments arising at any time your child/children are participating and/or traveling to participate with the Atlanta Celtics Program. Further, I hereby grant full permission to presenters of this program to use any photograph, videotape, DVD recording, or any other record of events for any purpose. Parent/Guardian signature below attest to your agreement to adhere to all the rules and regulations of the facilities events that are held and that you have read this registration form and grant full permission for your child to participate in the Atlanta Celtics Basketball Program. Parent/Guardian agrees to volunteer time during Atlanta Celtics sponsored local tournaments. Initial