Sports Basketball Registration Form printable pdf download

Sports Basketball Registration Form

FAIR LAWN ALL-SPORTS BASKETBALL

REGISTRATION FORM

“ALL-SPORTS FOR ALL KIDS”

OFFICE USE ONLY:

AMT $ _______

CHK # _______

PLEASE PRINT CLEARLY

FIRST NAME: ___________________ LAST NAME: _________________________

ADDRESS: ___________________________________________________________

BIRTHDATE: __________________________ AGE: _________ GRADE: _________

MALE: _________

FEMALE: _________ SCHOOL: _______________________

PARENT(S) NAME: ____________________________________________________

PHONE NUMBER: ___________________ CELL NUMBER ____________________

EMAIL ADDRESS: _____________________________________________________

(Coordinators and coaches communicate through email. Email provided MUST

be active!!!)

TRAVEL BASKETBALL PLAYER IN 2014-2015 SEASON:

YES ____ NO____

VOLUNTEER COACHES ARE NEED FOR ALL LEVELS. IF YOU ARE

INTERESTED IN COACHING, PLEASE FILL OUT THE BELOW:

YES, I WOULD LIKE TO COACH __________

PRINT NAME: _________________________

PHONE NUMBER: ______________________

EMAIL: _______________________________

(Email provided MUST be active!!!)

I ACCEPT FULL RESPONSIBILITY FOR ANY INJURY SUSTAINED BY MY CHILD RESULTING

FROM TRAINING, COMPETITIVE PLAY, TRAVEL TO AND FROM GAMES OR OTHER ASPECTS

OF HIS/HER PARTICIPATION IN THIS PROGRAM. I HEREBY GRANT PERMISSION FOR MY

CHILD TO PARTICIPATE IN THE BASKETBALL PROGRAM. I HAVE READ AND UNDERSTAND

THE ABOVE REGISTRATION FORM.

_____________________________________

______________________

PARENT/GUARDIAN SIGNATURE

DATE

Sports Basketball Registration Form