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  • 2011-2012 Hawks Basketball Registration Form: Player Information

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    Michael Turner
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    This document is a registration form for the 2011-2012 Hawks Basketball program. It collects player information like name, school, grade, date of birth, age, sex and medical conditions. It also collects parent/guardian contact information such as name, email, address, phone numbers and emergency contacts. By signing, the parent agrees to terms that recognize risks of participation, release the program from liability, authorize medical treatment if needed, and allow photos for publicity.

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    Hawksapplication (4).doc

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    This document is a registration form for the 2011-2012 Hawks Basketball program. It collects player information like name, school, grade, date of birth, age, sex and medical conditions. It also collects parent/guardian contact information such as name, email, address, phone numbers and emergency contacts. By signing, the parent agrees to terms that recognize risks of participation, release the program from liability, authorize medical treatment if needed, and allow photos for publicity.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    12 views1 page

    2011-2012 Hawks Basketball Registration Form: Player Information

    Uploaded by

    Michael Turner
    This document is a registration form for the 2011-2012 Hawks Basketball program. It collects player information like name, school, grade, date of birth, age, sex and medical conditions. It also collects parent/guardian contact information such as name, email, address, phone numbers and emergency contacts. By signing, the parent agrees to terms that recognize risks of participation, release the program from liability, authorize medical treatment if needed, and allow photos for publicity.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    PLAYER INFORMATION

    Last Name: School: Grade: Date of Birth:

    2011-2012 Hawks Basketball Registration Form


    First Name:

    Age:

    SEX: Program Code: HIB33169

    MALE

    FEMALE

    AGE DIVISION
    5-6 7-9 under 11 under 13 under Please list any medical conditions, allergies, or medications for the above participant that should be considered. Did you attach: ____ Copy of Birth Certificate ____ Copy of most recent report card (travel team only)

    PARENT/GUARDIAN INFORMATION Name: E-mail: Address: Zip Code: Mobile Phone: COMMUNICATION
    Can we send you updates by text? Yes No Can we send you email updates? Yes No

    City: Home Phone:

    State: Alternative Phone:

    EMERGENCY CONTACTS NAME HOME PHONE MOBILE PHONE

    I hereby certify that my child is of normal health and capable of full participation in the Youth Inc of Florida and the Hawks Basketball Club (HBC). Recognizing that the Youth Inc of Florida and HBC will do its best to ensure a safe experience, I understand that there are risks and hazards inherent both from my childs participation in the program and from transportation to and from the program; I agree to assume these risks. I hereby release the Youth Inc of Florida and HBC, its employees, volunteers, and agents from any and all claims from injury, illness, death, loss, or damage, resulting from my childs participation in the youth programs. I hereby authorize the Youth Inc. of Florida and HBC, its coaches, staff, and volunteers to obtain medical treatment for my child in event those emergency contacts cannot be reached. I understand that the Youth Inc of Florida and HBC does not provide any accident or health insurance for its members and participants and I further understand that it is my responsibility to provide such coverage. I give permission for my childs picture to be taken and to be used for publicity purposes. I have read and voluntarily signed this waiver and release of liability, and I agree that no oral representations, statements, or other inducements to sign have made apart from what is written on this form.
    PARENT/GUARDIAN SIGNATURE: ______________________________________________ DATE: _________________________________

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