BCWB Fall Basketball League 2015

Mail-In Registration Form

Mail to - BCWB, P. O. Box 3528, Frederick, Md. 21705

$135.00 Per Player - Print this form

Boy      Girl    Team (Team must submit roster ASAP)   

Skill Set/Level   Beginner  Intermediate  Advance

 

Player First and Last Name    

(If team - enter name as team name)                                      Player/Team  Age and  Grade                                
     

Email Address                                                                                           School 

                                                  

 Home Phone                                  Cell Phone                                     Medical Problems?

      

Comments:  Have a players you like to play on the same team?  

Have a coach you like to play on his/her Team?

T-shirt Size     Youth    Small   Med    Large    XLarge     

                           Adult     Small   Med    Large    XLarge   XXLarge 

No Refunds after:     August 1, 2015 

I have read the above and agree to the league conditions:   

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.