A3Athletics

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>>>>>>>>>>2019 Spring Summer Tryout Registration Form <<<<<<<<<< Click Here!!!

PLAYER INFORMATION

* First Name:

* Last Name:

* Street:

* City:

* State:

* Zip Code:

Home Phone:

* Email:

* Birthdate:

* Grade (According to the 2018-2019 academic school year):

* Gender:

* Height:

* Jersey size (Top):

* Jersey size (Shorts):

* What School do you attend?:

* GPA:

* What are your Spring/Summer goals?:

PARENT/GUARDIAN #1

* Firstname:

* Lastname:

* EMail:

Home Phone:

Work Phone:

* Cell Phone:

PARENT/GUARDIAN #2

Firstname:

Lastname:

Email:

Home Phone:

Work Phone:

Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

* Emergency Contact:

* Phone:

* Relationship to Player:

WAIVER INFORMATION

RISK AND WAIVER OF LIABILITY FORM AND MEDIA RELEASE

As the legal guardian of _________________________________________________________, I hereby consent to the aforementioned person participating in the A 3 Athletics Basketball Club program including but not limited to; tryouts. I acknowledge that my son/daughter is in good physical condition and capable of fully participating in all events and activities. I recognize that potentially severe injuries can occur in any activity that is associated with basketball and youth sports.

I understand that this is the express intent of the A 3 Athletics Basketball club, to provide for the safety and protection of my child and, in consideration for allowing my child to try out for the A 3 Athletics Basketball Club, I hold the club totally harmless.

I hereby forever release A 3 Athletics basketball Club and its Directors, Coaches, Trainers and staff, AAU Boys and Girls Basketball and/or facility used by A 3 Athletics Basketball Club, its officers, employees, coaches and owners from all liability for any and all damages and injuries suffered by my child while under the instruction, supervision or control of any of the above so mentioned.

As legal guardian of the aforementioned person, I hereby agree to individually provide for the possible future medical expenses which may be incurred by my child as a result of any injury sustained while trying out for the A 3 Athletics Basketball Club, AAU Boys and Girls Basketball and/or any facility used by the A 3 Athletics Basketball Club and its officers, employees, coaches and owners.

In case of an emergency, I authorize A 3 Athletics Basketball Club staff to administer first aid to my child/or take my child to a physician or hospital for further treatment. I fully understand that I am responsible for all medical expenses. This acknowledgement of risk and waiver of liability, having been read thoroughly and understood completely, is signed voluntarily as to its content and intent.

I hereby authorize and give our full consent to A3 Athletics to copyright and/or publish any and all photographs, videotapes, film and any other form of visual/audio communications in which my child appear while attending any A 3 Athletics event. I further agree that A 3 Athletics may transfer, use or cause to be used, these above mentioned communications for any exhibitions, public displays, publications, commercials, art and advertising purposes, and television programs without limitations or reservations.

I/we agree with the above *

* indicates required fields

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>>>>>>>>>>2019 Spring Summer Tryout Registration Form <<<<<<<<<< Click Here!!!