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SPONSORSHIP Opportunities

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Registrations are now CLOSED for the 2012-2013 program year.

Questions regarding registrations may be addressed to

If you prefer to submit a paper application
click here for a downloadable
BaskeBasketball Registration Form in PDF format.
Click here for a downloadable Basketball Code of Conduct Form in PDF format.

Submit paper registrations to
the Basketball Commissioner at 165 Hunters Ridge Drive, Harrisburg PA 17110.
Mail-In registrations must be PRE-APPROVED by the Commissioner -- Email contact is


Online Registrations are CLOSED for 2012-2013.
Those interested in being placed on the waiting list should contact the Commissioner at

If you do not have a copy of the PDF Reader, see the bottom of this page.

Please note that the league only accepts 60 Pony players (8-10 yr olds),
60 Midget players (11-14 yr olds), and 20 Skillbuilder players (6-7 yr olds).
(The reason for this is due to gym availability for practices and games.)

Basketball Registration Form
Form can be used for up to 3 participants from one family at the same address.

Registration Process -- Please complete all steps:
Complete this Registration Form
PLEASE NOTE -- if you are registering more than 3 participants, please complete an additional form
v Make Payment (Bottom of this page)
PLEASE NOTE -- Your registration is NOT COMPLETE until your payment has been received.


Participant Child #1 First Name  
Participant Child #1 Last Name  
Age on December 31 2012  
Gender Male     Female
Birth Date (mm-dd-yy)  

If no additional participants from this family, skip to Address section.

Participant Child #2 First Name  
Participant Child #2 Last Name  
Age on December 31 2012  
Gender   Male     Female
Birth Date (mm-dd-yy)  

If no additional participants from this family, skip to Address section.

Participant Child #3 First Name  
Participant Child #3 Last Name  
Age on December 31 2012  
Gender   Male     Female
Birth Date (mm-dd-yy)  
Please note that all participants registered on this form
MUST reside at the SAME ADDRESS.
Street Address  
ZIP Code  
Home Telephone  
Alternate Phone  
Email Address  
Participant #1 School enrolled 2012-2013  
Participant #1 Grade enrolled 2012-2013  
Participant #1 T-Shirt Size  
Participant #1 # years Paxton experience  6+
Participant #2 School enrolled 2012-2013    
Participant #2 Grade enrolled 2012-2013    
Participant #2 T-Shirt Size    
Participant #2 # years Paxton experience   6+
Participant #3 School enrolled 2012-2013    
Participant #3 Grade enrolled 2012-2013    
Participant #3 T-Shirt Size    
Participant #3 # years Paxton experience   6+
Parent/Guardian First Name  
Parent/Guardian Last Name  
Parent/Guardian Phone  
Parent/Guardian Email  

Attention parents: Please volunteer and help our league.
Without you the basketball league will not exist.
Please sign up for the following positions to help the league.

Please indicate how you can help
support the program this year
(Check all that apply)
  Head Coach              Assistant Coach
Game Day Manager    Hall Monitor
Volunteer Committee  Fundraising Committee
Scorekeeper             Electronic Scoreboard
School Security
Emergency Medical Information/Consent for Treatment
I do give consent for treatment of the child named above in any case of my unavailability, should any emergency need, medical or surgical, arise for my child during the season. Should a specialistís advise or services be required, please list preference:
Emergency Contact  
Emergency Contact Home Phone  
Emergency Contact Cell Phone  
Hospital/Emergency Facility Preference  
Family Doctor  
Doctor Phone  
Health Insurance Company Name  
Policy #  
Group #  
Tetanus Injection -- Participant 1   (date -- mm-dd-yy)
                                                              Enter "00/00" if unknown
Tetanus Injection -- Participant 2   (date -- mm-dd-yy)
                                                              Enter "00/00" if unknown
Tetanus Injection -- Participant 3   (date -- mm-dd-yy)
                                                              Enter "00/00" if unknown
Please list allergies, especially to any food, fluid, bee stings or medicines
[Identify allergies by participant]
List Medical Conditions we should be aware of
[Identify medical conditions by participant]
Does your child wear contacts? Yes    No
If YES, which child(ren)?
List medications your child is currently taking
[Identify medications by participant]

Consent and Waiver

By my electronic signature and submitting this form, I, the parent or guardian of the child(ren) named above, hereby give my approval for his/her/their participation in any and all the activities required during the current basketball season. I assume all the risks and hazards incidental to the conduct of the activity, as well as transportation to and from such activities. I hereby release, absolve, indemnify and hold harmless PAXTON ATHLETIC ASSOCIATION (the association), the organizers, sponsors, coaches, supervisors, and/or any other persons placed in a supervisory capacity over such activities, and hereby waive any claims which may arise because of this agreement and/or activities.

I hereby attest that I carry insurance and fully agree that any injuries incurred by the player(s) during these activities will be charged to this insurance. I understand that the Association carries an excess insurance policy which will, within the limits of such policy, pay any medical, dental, and/or hospital expenses not paid by my insurance, providing such injury is reported to the association within forty-eight hours (48) of such injury.

I understand that there will be additional equipment required by the player(s) that is not furnished by the association. Sneakers, socks, gym shorts are some of the items that may be required and they will be my responsibility.

To all the above I formally agree and give my full consent and approval to this/these player(s) entering the basketball program.


Photo Release for Children Under 18 Years of Age

I hereby grant Paxton Athletic Association to use the photo and or other digital reproduction of his/her physical likeness for publication processes, whether electronic, print, digital or electronic publishing via the Internet.


Paxton Basketball
Spectator/Player Code of Conduct Policy

The Paxton Athletic Association Board of Directors and the Paxton Basketball League has adopted the following conduct policy towards spectators, coaches, league officials and players.

I.  The following WILL NOT BE TOLERATED DURING Paxton A.A. BASKETBALL EVENTS or on Central Dauphin School District property.

  1. Unsportsmanlike behavior from any staff member, coaches, players, parents, family members and spectators during Paxton Basketball practices, games, and Events on Central Dauphin School District Property or other venues were Paxton Basketball teams participate in.
  2. Any inappropriate behavior that is considered detrimental to our children, participants, or this organization and its members during basketball functions or on Central Dauphin School District Property.
  3. Fighting or other violent behavior from any person involved in any activity of Paxton Basketball or on Central Dauphin School District Property.
  4. Spectators interference with officials of the on-going game which may not set a good example for players. This may include harassment, verbal language, and conversation related to game while game is in progress with the official. Officials include coaches, scorekeepers and PIAA referees.
  5. Spectators interference with league officials during any game will not be tolerated. This includes before, during and after any league game during any point of the season and post-season tournament. Interference includes verbal, physical, and another other kind of abusive view expressed by the spectator.
  6. Failure to follow all rules of said basketball program related to code of conduct.

II. The Paxton Athletic Association reserves the right to ask any person to remove themselves from a Paxton A.A. basketball event if Basketball commissioner and/or league coordinator involved in the current game all agree that the action warrants it.

  1. At no time will a member of the Paxton A.A. basketball program enter into a physical altercation trying to remove a person(s) from any basketball event.
  2. Once a person(s) has been asked to leave a Paxton Basketball event they may not return to a Paxton Basketball venue until the Paxton A.A. Board of Directors has agreed to allow that the person(s) back into Paxton Basketball functions. This will be at the next regular scheduled Paxton A.A. board of directors meeting where all parties can state their case of reservations. (1st Thursday of every month)
  3. Any person will be held liable for damage of fines incurred during an event such as fines levied by PIAA referees, CDSD and/or the Paxton Athletic Association.

FOR 2012-2013

The Paxton Athletic Association requires each player in the associationís basketball program to sell fifteen (15) items in the designated fundraiser. Failure to sell fifteen items will prevent the player from playing in the post season playoffs, being considered for post season all-stars, and receiving participation awards or trophies which may be awarded to other team members who sold at least ten items.

This season the association will permit a buy out from the fundraiser for $60 per player over the registration cost. This amount is to be paid at registration.

The association does not permit players to wait until they see whether they would make an all-star team or otherwise be eligible for trophies to decide to sell ten items or buy out.

This policy is mandated by the board of directors and cannot be changed by the commissioner or any coach.

Complete Fundraiser information can be downloaded here.

Type of payment to be submitted
Secure payment form is at bottom of this page,
 and must be submitted separately
after completing this Registration Form.


PLEASE NOTE that if you chosse the FUNDRAISER option you must contact Joe Acri
during the month of September to receive your fundraiser information. 
Joe may be contacted at

Parent or Guardian Electronically Signing Form  
Today's Date   mm-dd-yy

Your registration is not complete
until your PAYMENT has been received.
Please come back to this page to complete your payment (below).

Please add any Comments or Questions you may have about the Paxton Basketball program


Try-Out and Evaluation Schedules will be available soon.


DO NOT submit an online payment without first receiving approval from the commissioner.

v Please submit your Registration Payment here.


PayPal payment processing accepts
Credit or Debit Cards and PayPal accounts

Solution Graphics

To complete your registration with an online secure payment using a
Credit or Debit Card, please
[1] choose Individual,
or 3-Child,
[2] whether you choose the
Buyout option, and then
[3] click the Paxton Payment button.

Choose Payment Level
Student(s) covered by payment
Enter Comments here

[Adobe Acrobat Reader required to use PDF Application.]
Clilck image to get information and download the FREE Acrobat Reader  Click image to get FREE Acrobat Reader to open and print PDF files.

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PO Box 6008, Harrisburg PA 17112  |                   |

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