Registration - 1. Registration DIOCESES OF OAKLAND CATHOLIC YOUTH ORGANIZATION (CYO) Health Authorization, Release Form
1. Registration DIOCESES OF OAKLAND CATHOLIC YOUTH ORGANIZATION (CYO) Health Authorization, Release Form

Please fill in the below fields in order to register your child for the Good Shepherd Basketball CYO Program 2025-26 winter season. If your child is new to the program, a copy of his/her birth certificate will be required. The program is open to boys and girls in the grade level of 2nd, 3rd, 4th, 5th, 6th, 7th and 8th. Please fill out the online form and submit no later than September 19, 2025 with payment. Late registration will not be accepted if the grade level has been filled or if the last uniform order has been submitted. Each child must be submitted separately and not on one form. After submission a window appears allowing you to view input data and print a copy of the form. This printed copy should be kept for verification of registration.

PAYMENT DUE BY SEPTEMBER 19, 2025 to participate this season. First day of league play is Saturday, November 1, 2025. (Refunds must be requested no later than October 1st).    

Name
Address
City, State Zip
Phone
Email
Eligibility Guidelines:

1. Reside within the parish boundaries -or- within city limits with other parishes written permission from pastor.
2. Currently attends St. Peter Martyr school.
3. Have attended St. Peter Martyr -or- Good Shepherd Faith Formation (CCD) for the 2025-2026 school year and will enroll prior to September 1, 2025 to attend Faith Formation for the current 2025 - 2026 school year.
4. Not currently playing for another CYO program.
5. Age Eligiblity/School Grade: 2nd - 8th
School Grade in September 2025
Gender
Returning Player
Returning player number
Parish (Church)
School
Other school not listed
Birth Date
Parents/Guardians Name
Work Phone
Cell or Other Number
Receive Text
Cell or Other Number
Receive Text
Other Phone
IN CASE OF EMERGENCY, NOTIFY PERSON OTHER THAN PARENT/GUARDIAN
Name
Phone
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HEALTH AND MEDICAL INFORMATION
Family Physician
Phone
Address
Medical Plan
Plan #
Do you authorize the adult leader to authorize medical treatment for your child in an emergency, as considered necessary by the attending physician?
State any reason why you do not want medical care given to your child in an emergency
List all conditions (such as allergies, seizures) for which your child requires ongoing medication and state the type of medication given. Input None if applies
Has your child had difficulty with the following? Either type in None or each one that applies. Asthma - Fainting Spells - Convulsions - Diabetes - Heart - Eyes - Ears - Nose - Throat - Lungs - Digestion - Menstrual Problems -
Has your child had difficulty with others not listed? Input None if applies
List any physical restriction for any sport activity on the basis of medical condition. Input None if applies
State the date of your child's last physical examination
IT IS STRONGLY RECOMMENDED THAT EACH CHILD HAVE A PHYSICAL EXAMINATION PRIOR TO PARTICIPATION IN ANY SPORTS ACTIVITY