BOOM Basketball North Shore

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2020 Registration - Girls 7th Grade

PLAYER INFORMATION

* First Name:

* Last Name:

* Grade (2019/20 school year):

Birthdate:

* Uniform Size (if needed):

Uniform # requested (no guarantees):

* Street:

* City:

* State:

* Zip Code:

* Home Phone:

PARENT/GUARDIAN #1

* Firstname:

* Lastname:

* EMail:

* Cell Phone:

WAIVER INFORMATION

My son/daughter is in good health and has my full permission to participate in the Boom Basketball program. He/she has no previous illness or bodily injury that is contradictory to participation. In the event I cannot be reached, I hereby authorize emergency or other medical treatment for my child that may be deemed necessary by attending medical personnel while he/she is attending a Boom Basketball event. I, the undersigned, individually and as the parent or guardian of the above minor, ask that he/she be admitted to participate in Boom Basketball program. In consideration of such admission, I do hereby release, discharge, and hold harmless Boom Basketball, its officers, agents, employees of and from all causes, liabilities, damages, claims or demands whatsoever on account of injury or accident involving said minor arising out of the minor’s attendance at Boom Basketball events or in the course of competition and/or activities in connection with the event.

I/we agree with the above *

* indicates required fields

IMPORTANT: Online Payment with credit cards is not active for this form

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2020 Registration - Girls 7th Grade