Oxford City HOOPS Basketball

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PLAYER REGISTRATION FORM 2015-16

PLAYER INFORMATION

* First Name:

* Last Name:

* Address:

* City:

County:

* Post Code:

* Home Phone:

Mobile Phone:

* Email:

* Birthdate:

Gender:

Grade:

SENIOR PLAYERS

* Profession:

* Educational Level:

Work EMail (If different from above):

Employer:

Work Phone:

Mobile Phone:

PARENT/GUARDIAN

Firstname:

Lastname:

Email:

Home Phone:

Work Phone:

Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

Emergency Contact:

Phone:

Relationship to Player:

Favourite Team:

Favourite Player:

WAIVER INFORMATION

Authorise OHBC to take pictures of my child playing basketball and publish them on any of the Club web sites.

I/we agree with the above *

FEES INCLUDE:

EB Membership & Standard Insurance, Training Sessions, Game Officials' Fees, Use of Equipment and Playing Uniforms & Club Playbook:

Please ensure you supply Passport size pictures.
National League x 4
Local League x 2
CVL / BSE x 2

National League: Copy of your Passport

Oxford HOOPS Basketball Club
HOOPS House
12 White Road
Oxford
OX4 2JJ

Signature:

Date:

Signature:

Date:

* indicates required fields

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

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PLAYER REGISTRATION FORM 2015-16