St. Dominic's Parish CYO Program

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2025-26 CYO 6th Grade Boys Basketball

PLAYER INFORMATION

* First Name:

* Last Name:

* Street:

* City:

* State:

* Zip Code:

* Home Phone:

* Birthdate:

* Email:

* Gender:

* Grade (A/O 9/2025):

* School attending:

PARENT/GUARDIAN (Emerg Contact)

* First name:

* Last name:

* EMail:

* Home Phone:

Work Phone:

* Cell Phone:

* Short Size:

* Uniform Jersey Size:

* Last Years Uniform #:

WAIVER INFORMATION

1. I/We, the parent(s)/guardian(s) of the above-named candidate for a participation in the St. Dominics CYO program hereby give my/our approval to participate in any and all related activities, including transportation to and from such activities.

2. I/We know and fully understand that participation in any sport may result in serious injuries and/or death and protective equipment does not prevent all injuries to players. I/We do hereby waive, release, absolve, indemnify, and agree to hold harmless St. Dominics Parish and CYO program, its Officers, Coaches and other Volunteers, all Facilities Owners/Managers, the organizers, sponsors, supervisors, participants, and persons transporting my/our child to and from activities from any claim arising out of any injury and/or death to my/our child whether the result of negligence or for any other cause.

3. I/We agree to pay any and all fees associated with my/our child’s(rens) participation on a team as well as for any league play or tournaments that the team participates in. Such fees will be paid promptly upon the request of the St. Dominic's CYO Program.

4. I/We will furnish a certified birth certificate of the above-named candidate to St. Dominic's CYO if requested.

* Electronic Signature (type your name):

I/we grant permission for my child to play on a St. Dominic C.Y.O. Basketball team. *

I hereby grant permission for St. Dominic C.Y.O. to list my child's name on their online roster and use any photos taken of my son/daughter for posting on their web site. I waive any rights or interest that I may have in all or any images.

I hereby grant Saint Dominic C.Y.O. permission to use any pictures or likeness of my child participating in any Saint Dominic C.Y.O. athletic competition for publication in any media or local news outlet. !

* Parent, Guardian or Adult E-mail:

* indicates required fields

If uniform is needed please check box($45)

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2025-26 CYO 6th Grade Boys Basketball