Shooting Stars Basketball Registration

Player's Full Name

Street Address 1

Town / City

Postcode / Zip

If this registration form is for an additional child, please indicate the name of the first child registered from your family. It helps us with our records. Thank you!

Date of Birth*

Age*

Grade*

Division*

Boys

Girls

I/We, the parent(s)/guardian(s) of the above player hereby give my/our approval to participate in any and all program activities. I/We assume any and all risks and hazards incidental to such participation including transportation to and from these activities. I/We do hereby waive, release, absolve, indemnify and agree to hold harmless the CVCO Shooting Stars Basketball officers, organizers, sponsors, supervisors, volunteers, coaches, participants and those persons transporting my/our child, whether the result of negligence or for any cause. I/We certify that my/our child is covered by a health insurance policy. In case of emergency, that my/our emergency contact and/or family physician cannot be reached, I/we hereby authorize that my/our child be attended by another licensed physician who is available.

I HAVE READ AND UNDERSTAND THE ABOVE CONDITIONS AND AGREE TO ALLOW MY CHILD TO PARTICIPATE.

Parent/Guardian Name

Signature (please type FIRST and LAST name)*

Checkbox Group*

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.

Date

Phone Number

Email Address

I/WE OFFER TO VOLUNTEER OUR SERVICES IN THE FOLLOWING CAPACITY:

Coach

Assistant Coach

Referee

Volunteer Name

Volunteer Phone Number

Volunteer Cell Number

User Email*

Password*

Shooting Stars Basketball Registration

Payment Details

Your Title Goes Here