Northbridge Youth Basketball Association

Subscribe to our Newsletter

2017 Winter Clinic

PLAYER INFORMATION

* First Name:

* Last Name:

* Zip Code:

* Birthdate:

* Gender:

* Current Grade (2017-2018):

* Shirt Size:

PARENT/GUARDIAN #1

* First Name:

* Last Name:

* EMail:

Home Phone:

Work Phone:

Cell Phone:

PARENT/GUARDIAN #2

First Name:

Last Name:

Email:

Home Phone:

Work Phone:

Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

* Emergency Contact:

* Phone:

Relationship to Player:

WAIVER INFORMATION

I, the parent of the above named child, hereby give my approval for my child’s participation in any and all of the activities of the Northbridge Youth Basketball Association during the Winter Clinic.
I assume all risks and hazards incidental to the conduct of any activities.
I do further hereby release, absolve, indemnify and hold harmless the Northbridge Youth Basketball Association, the Organizers, Board of Directors, Coaches, Sponsors, Town of Northbridge, and official participants.

I/we agree with the above *

* indicates required fields

OUR SERVICES

LOCAL SPORTS

ELITE

2017 Winter Clinic