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DFW - Fort Worth - Athlete Training Registration
(Athlete Training fee - $30 per hour) Minimum 2 hours
This form allows one player to register for training in the Fort Worth Texas area.
This also allows parents to provide contact parent/guardian information, permission consent, and select hours of training and focus.
Training includes, Coach Evaluation, Pointers, Conditioning, and Skill Focus
Training Coaches:
Coach Ryan Smith 737-990-5915
Coach Janell Smith 737-990-5914
ATHLETE INFORMATION
*
First Name:
*
Current School Attending:
*
Last Name:
*
Street:
*
City:
*
State:
*
Zip Code:
*
Player Cell #:
*
Home Phone:
*
Birthdate:
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
*
Email:
*
Weight:
*
Height:
*
Position:
*
Gender:
M
F
Grade:
7th
8th
9th
10th
(Parents and Guardians only must complete and submit this form)
PARENT/GUARDIAN #1 (Completing this form)
*
First Name:
*
Last Name:
*
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:
Insurance Carrier:
Policy #:
WAIVER INFORMATION
PARENT CONSENT / MEDICAL WAIVER / AND RELEASE
The Texas Extreme Basketball Organization and any facilities where tryouts, training, practices, or games will be played will assume no liability for injury or damages arising from the results of the above named Athlete's participation.
Due to the strenuous nature of basketball, the Athlete participating and their parents are urged to consult with their physician concerning the Athlete's fitness and ability to participate. Basketball presents certain risks and hazards, which the participating athlete is urged to consider and which the athlete assumes.
I hereby approve of the participation of my child, the above named athlete, in the Texas Extreme tryout or training program and consent to the emergency medical treatment for my child on my behalf. To the best of my knowledge, there are no physical or other conditions which will interfere with my child's participation.
Training Sessions: $30 per hour
($25 Travel fee outside of Fort Worth, Texas to the DFW area)
I/we agree with the above
*
* indicates required fields
Training Fee (Minimum 2 hours)($60)
*
Travel Fee($25)