Instructional Basketball League Signup Form

Player Information

Player Name

Grade

School

Age

Date of Birth

Parent/Guardian Information

Parent/Guardian Name

Phone

This address will receive a confirmation email

Emergency Contact Name

Emergency Contact Phone

Basketball Experience

Has the player played basketball before?

Yes No

Jersey Size

Liability Waiver and Release

I, the undersigned parent or guardian, understand that participation in basketball and related activities may involve physical activity and risk of injury. I voluntarily allow my child to participate in the instructional basketball league hosted by Grace Community Center. I release and hold harmless Grace Community Center, its staff, volunteers, coaches, and organizers from any claims, liabilities, damages, or injuries that may occur as a result of participation, except in cases of gross negligence or intentional misconduct. I certify that my child is physically able to participate in league activities.

By checking this box, you acknowledge acceptance of the above Liability Waiver and Release. The player cannot participate in the league without this release.

Parent/Guardian Signature

By typing your name in the field, you acknowledge that you understand this is an instructional league, and you give permission for your child to participate.

Date

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Instructional Basketball League Signup Form

Description

Please Fix the Following