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MoCo Warriors Basketball Organization
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MoCo New Player Registration
*
Player's First Name:
*
Player's Last Name:
Student Email:
*
D.O.B.:
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
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1994
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1996
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2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
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Gender:
Male
Female
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Address:
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Home Phone:
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School:
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Current Grade:
1
2
3
4
5
6
7
8
9
10
11
12
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Parent's Name:
*
Parent Type:
Mother / Step-Mother
Father / Step-Father
Legal Gardian
Grandparent
Other
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Email Address:
*
Parent's Cell Number:
2nd Parent's Name:
2nd Parent Type:
Father / Step-Father
Mother / Step-Mother
Legal Gardian
Grandparent
Other
2nd Parent Email Address:
2nd Parent Phone Number:
*
Emergency Contact:
*
Emergency Contact #:
Additional Email 1:
Additional Email 2:
Please list any medical conditions or known scheduling conflicts. (If None, then type "NONE"
*
Information:
Uniform information!
*
Jersey Size:
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult XXL
Adult 3X
*
Short Size:
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult XXL
Adult 3X
*
Shoe Size:
10 - 1
1 - 3
3 - 7
7 - 12
I hereby grant permission for my child to attend the basketball program that has been signed scheduled by the MOCO Warriors (which include league and tournaments). I understand that I am responsible for my child's insurance in case of injury. Furthermore, I understand that although safety precautions will be observed, MOCO Warriors, their employees, coaches, and agents will not be responsible for any personal lost by my child or for any injury sustained in the program. I also consent to MOCO Warriors, for the use of any photographs, CDs and video made of the program.
MOCO Warriors Basketball Association and its affiliates, coaches, and organizers do not assume any liability for injury or damages arising from participation in our program. Due to the strenuous nature of the activity, MoCo Warriors Basketball encourages each participate to consult his or her physician concerning fitness to participate in the program.
I understand that I must provide a copy of the player’s birth certificate to keep on file and in some cases may be required to bring proof of current grade (i.e. report card, schedule ) to play in certain tournaments.
A fee schedule will be submitted once the budget is completed. Fee schedules will not include additional tournaments that are added on an optional basis. All Fees are non-refundable.
MoCo Warriors is a competitive Basketball organization and all parties understand that their is no-must play rule!!
The uniforms will be provided on a loaner basis and it must be returned in good condition at the end of each season or when your child is no longer in the program, which ever comes first or their will be $150.00 due to replace it.
By signing this form the parent or guardian approves of their child's participation. In addition the parent or guardian assumes all liability for injury or damages during their child's participation in the program and hereby hold harmless MoCo Warriors or any of it's volunteers, employees, staff, and affiliates.
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Parent, Guardian or Adult E-mail:
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Electronic Initials Signature:
* indicates required fields