Youth
Spring Basketball League
April
6th to May 23rd - Individual
Player Registration Form
Please
Print this Form and Mail to: BCWB, P. O. Box 3528, Frederick, Md
21705
|
Registration
With Practice Time
8
weeks for 1 hour per week
- Starting two weeks
before start of the season |
Rates
Per Player |
Late
Registration Period |
$130
Per Player |
First
& Last Name
Home
Address
City,
State and Zip
Home
Phone
Cell Phone
Email
Address
School
Boys League
Girls League
Player
Talent Level Beginner
Intermediate
Advanced
Current
Grade 3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
T-Shirt
Size (Please
select one)
Adult
Small
Med
Large X-Large
XX-Large
Youth
Small
Med Large X-Large
Have
you ever played in any BCWB Basketball Program
Summer
League Fall
League TJMS
Mid-Maryland Team
AAU
Special
Request (coach, team, on same team with another player, etc.)
No
Refunds after: February 15, 2015
Medical
Release & Registration Agreement
The
undersigned, parent/legal guardian of the player requesting league
admittance, does hereby affirm that the applicant is in good health and
suffers from no illness, disability, or condition that requires the
taking of medication on regular basis unless that condition is disclosed
and approved. Furthermore, the undersigned has no knowledge of any
reason the applicant cannot participate in vigorous physical activity.
The undersigned hereby expressly agrees to be responsible for any
medical bills incurred in the treatment of any illness or accident. In
the event of any such accident or injury, I hereby consent to allowing
any of the league supervisors to procure any medical treatment deemed
advisable on behalf of my child or ward without prior consent. I
understand that, as a condition of admittance as a league participant,
the undersigned, on behalf of all parents and guardians, and behalf of
the applicant, hereby release Basketball Coaches Without Boundaries and
all other employees or agents of the league from any and all liability
in regards to injury or illness, either mental or physical suffered by
the league participant during or related to the league by the person or
entity against which the claim is made.
Signature
____________________________________________________ Date
___________________