COBRA Optimist 2026 Basketball Registration Form

Welcome to the On-Line COBRA Optimist Family Registration and sports release form. Cobra supports basketball, volleyball and wrestling.

First Child

Select one

$23 for a reversible basketball jersey. De-select this if you have a jersey in good shape from last year.

mm/dd/yyyy
Every attempt will be made to place you with the coach or team of your request.

Second Child

Select one

$23 for a reversible basketball jersey. De-select this if you have a jersey in good shape from last year.

First Name Last Name
mm/dd/yyyy
Every attempt will be made to place you with the coach or team of your request.

Third Child

Select one

$23 for a reversible basketball jersey. De-select this if you have a jersey in good shape from last year.

First Name Last Name
mm/dd/yyyy
Every attempt will be made to place you with the coach or team of your request.

I hereby give my full permission to my (son/daughter) to participate in Cobra Optimist Club of Council Bluffs activities. I agree to assume full responsibility in case of accident or injury while (he/she) is playing, traveling to or from the scheduled area, or representing (his/her) team in any manner, and do further hereby release and hold forever harmless Cobra Optimist Club of Council Bluffs, its agents and employees, from any liability for any personal injuries, including death or property damage, which may be incurred by my child while playing, traveling to or from the scheduled area, or representing the team in any manner, including but not limited to any claim alleging that the injury or damage was caused by defective equipment owned or furnished by the Cobra Optimist Club of Council Bluffs, or by negligence in the supervision of my child or others. It is the responsibility of each parent or guardian to check their child's insurance for athletic injuries. This signature gives us permission to seek emergency medical care as deemed necessary. This signature also allows Cobra to post pictures on Facebook or our website that have been taken during Cobra Optimist Club of Council Bluffs activities.

Cobra uses PayPal to process your credit / debit card. You do not need a PayPal account to pay with PayPal. Please have your credit / debit card ready before proceeding. After hitting the Submit button, you will be forwarded to PayPal. Your registration will not be complete until you finish with PayPal.