DOGS (Defense Or Go Sit)

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Player Information Form

PLAYER INFORMATION

* First Name:

* Last Name:

* Street:

* City:

* State:

* Zip Code:

* e-mail address:

Player's Cell Phone:

Cell phone Carrier:

* Home Phone:

* Birthdate:

* Gender:

* Grade:

PARENT/GUARDIAN #1

* Firstname:

* Lastname:

EMail:

Home Phone:

Cell Phone:

Cell phone carrier:

PARENT/GUARDIAN #2

Firstname:

Lastname:

Email:

Home Phone:

Cell Phone:

Cell phone carrier:

MEDICAL/EMERGENCY CONTACT INFORMATION

* Emergency Contact:

* Phone:

* Relationship to Player:

WAIVER INFORMATION

I hereby certify that all information above is correct and in consideration of participating in this or any DOGS (Defense Or Go Sit)Games, Practices, or Clinics that I assume full responsibility for my son, listed above and that I agree not to hold responsible DOGS (Defense Or Go Sit)its members, coaches, or other employees on account of any injury or loss or damage suffered as a result of participating in this or any DOGS (Defense Or Go Sit) event, including but not limited to games, practices, or travel to and from these activities.
I also agree not to hold any Coach or any assistant coaches responsible on account of any injury, or loss, or damage suffered as a result of participating on a DOGS (Defense Or Go Sit) basketball team.

I/we agree with the above *

* Submitted by (Parent's Name):

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