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Westlake Fundamentals Registration & Release
*
Name:
*
Street:
*
City:
*
Zip Code:
*
Grade:
1
2
3
4
*
T-shirt Size (Example YM, AS):
*
Parent's Names:
*
Main Email:
*
Main Phone Number:
Additional Email (Optional):
Additional Phone (Optional):
*
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 Westlake Basketball Games, Practices, or Clinics that I assume full responsibility for my son/daughter, listed above and that I agree not to hold responsible Westlake Basketball, 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 Westlake Basketball 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 coach responsible on account of any injury, or loss, or damage suffered as a result of participating on a Westlake Basketball team.
I/we agree with the above
*
*
Submitted by (Parent's Name):
* indicates required fields