Email*

Name*

Phone Number*

High School*

Position Played*

High School Basketball Coach*

Father's/Mother's Name*

Your Mailing Address*

Statistics (Averages, Records, Etc.)*

Most Recent Grade Point Average*

Letters Won In Basketball & Other Sports*

Hobbies*

Do you plan to attend college?*
YesNoMaybe

If Yes......Where do you plan to attend and what will you study?*

Sweatshirt Size*
XSSMLXLXXL

 
Athlete Photo Upload* 10Mb max file size

 
Signed Physical Form* 5Mb max file size

 
Parent Player Agreement Form* 5Mb max file size

 
Payment Options - $200*
Venmo @Midland-Roundtable-1Credit Card - Call 406.672.3576 to make paymentMail Check(s) to Midland Roundtable Po Box 248 Billings, MT 59103
 
List sponsor and amount as you would like to see them in the program. (Optional)