Mass Silk Basketball Club

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Mass Silk AAU Registration

PLAYER INFORMATION

* First Name:

* Last Name:

Street:

City:

State:

Zip Code:

Home Phone:

* Birthdate:

Email:

Gender:

Grade:

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 Statement
The parent/gaurdian states that he/she understands that the Mass Silk Basketball Club are not and shall not be responsible
for or liable for any illness, or injury to person or damage to property resulting from the program in which the undersigned is enrolling or being
enrolled or from his/her participating in said program, and the participant and the parent/gaurdian, if the participant is a minor or under other legal
disability, hereby forever releases and holds harmless the said: Mass Silk Basketball Club, its employees, agents and representatives from
any and all claims of any kind that the participant, or the undersigned or their respective heirs, executors, administrators, or assigns may have or
claim to have resulting from participation in said program. Also, the parent/guardian and the participant authorize the Mass Silk Basketball Club
to use at its discretion any photograph (s) (black/white or color) taken of the participant in the program and waive any and all claims that
the participant or parent/gaurdian or their heirs, executors, administrators, or assigns may have or claim to have resulting from such photograph(s)
or reproductions thereof.
I have read and understand the waiver statement: registration invalid without Agreement and/or signature of adult.

*** Insert your waiver information here ***

I/we agree with the above *

* indicates required fields

individual fee($350)

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Mass Silk AAU Registration