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Registering for the MWBA is easy; either fill out our online form below, or click here to download a printable form and fax it to 905-569-6929 . Adobe Acrobat or other PDF reader required.

NEW Fee Payment Policy: Full fees are required at point of registration. Please mail your certified cheque or money order to the MWBA office with your application form or the name of youth on the Memo line of the cheque.

The Skills Development Season: It runs for 20-weeks, with some of the lowest fees in Mississauga! It starts the weekend of Oct 13 for 10 weeks, ending Dec 15 and continuing the weekend of Jan. 5 and runs for another 10 weeks ending the weekend of March 8.

If you have any questions regarding our program or our registration form, please feel free to contact us.

Program:

St. Famille - Saturdays
1780 Meadowvale Blvd. (Meadowvale and Derry Rd.)

  Program Age Time Price
Novice 8-9 9:00-11:00 $170
Atom 10-11 11:00-1:00 $175
Bantam 12-13 1:00-3:00 $200
Midget 14-15 3:00-5:00 $200
Miniwolves 6-7 3:00-4:30 $150

 

Information type
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Family Guardian
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Parent/Guardian 1:  
Relationship: Mother Father Other
Salutation: Mr. Mrs. Ms. Other
Last Name:
First Name:
Home Telephone:
Business Telephone:
Cellular Telephone:
Fax Number
Email:
Parent/Guardian 2:  
Relationship: Mother Father Other
Salutation: Mr. Mrs. Ms. Other
Last Name:
First Name:
Home Telephone:
Business Telephone:
Cellular Telephone:
Fax Number:
Email:
Secondary Contact (if above cannot be reached):  
Name:
Telephone Number:
Relationship to Participant:
Mailing Address of Family:  
Street:
City:
Postal Code:
Billing Address:
(If it is the same as mailing address, please enter the word "same" in every field.)
Street:
City:
Postal Code:
Phone Number:
Athlete Information:  
Surname:
First Name:
Commonly Used Name:
Sex: Male Female
Birthday:
Health Card Number:
Previous Basketball Experience (if any):
Uniform Size:

Youth: S M L XL

Adult: S M L XL XXL

Medical Information:  
Height (inches):
Weight (lbs):
Allergies:
Requires an Epi-Pen: Yes No
Immunizations Up to Date: Yes No
Is the athlete taking any prescription medication: Yes No
Please list any other medical concerns:
Doctor's Name:
Doctor's Telephone:
Please read the medical waiver.  
By checking this box, I am stating that I have read and agreed to the above medical waiver: Date:

Conditions of Registration:

  
Please read the terms and conditions.  
By checking this box, I am stating that I have read and agreed to the terms and conditions: Date:
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Media Release: 		..
I wish to support the Mississauga Wolverines, a non-profit organization. I allow photographs to be taken of my son/daughter playing basketball in order to support their multi-media promotional requirements for photographs, brochures, website and other marketing materials.
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By checking this box, I am stating that I have read and agreed to the above media release: 		..
Date:

*THIS APPLICATION MUST BE COMPLETED IN FULL BEFORE BEING CONSIDERED.

*PLEASE SEND PAYMENT TO: 2273 DUNDAS ST. W., UNIT 8, MISSISSAUGA, ONTARIO, L5K 2L8

*APPLICATION WILL NOT BE CONSIDERED UNTIL APPROPRIATE FEES ARE RECEIVED.