Elite Grassroots (B&G) Basketball

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DC SPORTS & NTX ELITE HOLIDAY HOOPS CAMP!!!

PLAYER INFORMATION

* First Name:

* Last Name:

* Cell #:

* Birthdate:

* Email:

* Gender:

* Grade:

PARENT/GUARDIAN #1

* Firstname:

* Lastname:

* EMail:

* Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

* Emergency Contact:

* Phone:

* Relationship to Player:

Insurance Carrier:

Policy #:

WAIVER INFORMATION

Liability Waiver

I, (Parent/Guardian) accept full liability & responsibility for my player, parents, spectators & anyone else affiliated with our team/organization and I/We do agree to indemnify and hold harmless DC Sports & its' affiliates from any and all claims, by or on behalf of any person, firm or agent arising from participation in DC Sports events.

I/we agree with the above *

Signature:

Date:

* indicates required fields

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DC SPORTS & NTX ELITE HOLIDAY HOOPS CAMP!!!