Basketball Sign-Up Sheet 2017-2018 printable pdf download

First Baptist Church of Gowensville

Age of youth as of 9-1-17

_____

5650 Highway 14 North

Jersey size

_____

Landrum, SC 29356

Division

___________________

Highland Baptist Church

3270 Highway 414

Paid Registration Fee

$_____

Taylors, SC 29687

BASKETBALL SIGN-UP SHEET 2017-2018

$30 per child--includes jersey * Must be of age by 9-1-17: Boys 5-12; Girls 5-14

Please complete this form and bring it with you to register.

Registration must be done in person and with the child present

during one of the following sign-up opportunities.

Thursday, 11-2-17, 6-8pm * Saturday, 11-4-17, 10-12noon * Monday, 11-6-17, 6-8pm

Late Sign-Up: Thursday, 11-9-17, 6-8 pm (extra $10 fee)

Participant’s Name:_____________________________Participant’s Age:____ Grade:____ Date of Birth:__________

Address:________________________________________________________________________________________

City:_________________________________Zip:_________________School:________________________________

Mother’s Name:___________________________Phone:_______________Email:_____________________________

Father’s Name:____________________________Phone:_______________Email:_____________________________

Emergency contact person in case parents cannot be reached:

Name:__________________________Relationship:__________________Phone:_____________________________

Allergies or physical limitations of participant:

_______________________________________________________________________________________________

(In addition to writing the above information, please also share this personally with the participant’s coach.)

Are you affiliated with a church in our area?_____ Name of church:________________________________________

I, the undersigned, do hereby consent to authorize the directors of the LifeSprings Basketball League to obtain for my

child such medical care, treatment, and hospitalization as they deem necessary. I, the undersigned, do hereby release,

remiss, and forever discharge the directors, coaches, staff, and First Baptist Church of Gowensville, Highland Baptist

Church, and Ebenezer Welcome Baptist Church from any and all claims, demand actions, or cause of action, past, pre-

sent, or future, arising out of any injury to my said child.

Furthermore, I understand that practices and games will be at three different locations: FBC Gowensville, Highland

Baptist Church, and Ebenezer Welcome Baptist Church. I will make every effort to have my child at the majority of

practices and games. Practice starts in late November. The season begins in January and concludes in early March.

Parent or Guardian Signature:_____________________________________________Date:______________________

Basketball Sign-Up Sheet 2017-2018