online registration - ONE FORM... ONE RECEIPT  

Please be advised that it is your responsibility to fully understand ALL INFORMATION on this page, as part of your Member In Good Standing (MIGS) status.   If there is any discrepancy between ANY infomation you receive, the content outlined on this page shall control.  Please click on the " * " to view a descripion of each section in full detail. 

 


LEGAL NAME *
DESIRED NAME ON PAYCHECK
EMAIL
 
ADDRESS
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country

MEMBERSHIP DUES *

FULL MEMBER ($155)

CBOA AFFILIATE ($100)

ASSOCIATE ($60)

  YES, I WILL TAKE SPLIT PAYMENT OPTION authorizing EBBOA to hold half of my dues (Full $75-Affiliate $50) from my first pay check and then the other half (Full $80-Affiliate $50) from my last check to pay for membership dues NEXT SEASON. 
 YES, I WILL TAKE "FULL PAYMENT 1ST CHECK" OPTION authorizing EBBOA to pull the full payment (Full $155-Affiliate $100) from my FIRST pay check to pay for membership dues NEXT SEASON. 
 YES, I WILL TAKE "FULL PAYMENT 2ND CHECK" OPTION authorizing EBBOA to pull full payment (Full $155-Affiliate $100) from my SECOND pay check to pay for membership dues NEXT SEASON.  
 NO, I WILL BE AN EBBOA ASSOCIATE MEMBER ONLY, WITHOUT PAYMENT OPTIONS . I WILL WORK AS AN ASSOCIATE MEMBER RESPONSIBLE FOR MY OWN MATERIALS & INSURANCE, A $60.00 MEMBERSHIP FEE, AND ASSIGNED GAMES AS NEEDED. 
PRIMARY ASSOCIATION *
YEARS OF EXPERIENCE
T-SHIR SIZE T ($10) *
# OF SHIRTS
JACKET SIZE ($55)
# OF JACKETS
T-SHIRT/JACKET PAYMENT
CONFLICT DATES *
 YES, I ACCEPT as I have read and understood the Conflict Dates Policy, will not accept high school ball games from another association on the above dates and expect a full schedule, based on my status and availability, from the East Bay Basketball Of 
 NO, I DECLINE as I can’t comply with the above policy dates because my first loyalty is with another high school association and I understand that I will have limited East Bay schedule, based on my status and availability, from the East Bay Basketbal 
CONFLICT OF INTEREST *  
HIGH SCHOOL YOU GRADUATED FROM
YEAR
SCHOOL(s) YOUR FAMILY MEMBERS (inside/outside of household)
CURRENTLY ATTEND to the best of your knowledge
3-Person Training
(3 for 2 PAY)
*
 YES, I ACCEPT taking less pay for "SPECIFICALLY CATEGORIZED and ASSIGNED" 3-Person games for the opportunity to gain experience in three person mechanics 
 NO, I DECLINE 
SCHOLARSHIP PROGRAM
# OF DONATED GAMES
 
DEDUCT DONATION FROM FINAL PAYCHECK
 YES 
 NO 
EBBOA REPRESENTATIVE
DATE / TIME

MM
/
DD
/
YYYY
ELECTRONIC SIGNATURE *

By checking this box, I am confirming usage of an ELECTRONIC SIGNATURE and that all information entered on this form is true and correct. This agreement takes effect when signed by the official.  Please print for your records.  Your submission will serve as your receipt.  EBBOA will have an electronic copy of this transaction.

 

NOTE: When you are redirected to the "Online Registration - DONE! GOOD JOB!", registration will be complete.

 

 

 

 

 

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