Girls Lil Rock Basketball 2017

The Lil’ Rock Basketball Program is open to girls grades 1-6. Most Games are played on Sunday afternoons during the months of November and December. Games are played at various Berrien Springs Public Schools. Practice times will be set by the coach. Forms are due by Monday, October 20th to avoid a $20.00 late fee. All participants are required to wear gym shoes. Lil’ Rock Basketball shirts are included in the registration fee.


Registration fee is due at the time of form submission

Registration fee: $48.00
Family rate: 2 Children $85.00 3 Children: $115.00
*$20.00 late fee if paid after October 20th, 2017
*$10.00 if not a resident of Village of BS, Oronoko Township, or Berrien Township

All Fields Required

Last Name

First Name





Street Address



Primary Phone

Additional Phone



Resident Of:

Does the aboved named participant have health insurance?

Mothers Name

Fathers Name

Emergency Contact (Name & Number)

Age Group:
1-3 Grade4-6 Grade

Shirt Size

Coaches are needed. If you are able to coach please fill in your name and phone number below. Please specify if you would like to head coach, assistant coach and your shirt size.

By submitting this form I the parent/guardian of the above named participant hereby, give approval for my child's participation in the Greater Berrien Springs Recreation Department activities for the sport indicated on this form. I assume all risks and hazards incidental to such participation. I do hereby agree to waive and hold harmless the Greater Berrien Springs Recreation Department Board and its agents from any claim arising or injury to my child. Also, I have read the GBSRD Code of Conduct, and Agree to follow its guidelines.

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