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Norris Area Basketball League/Player Registration Form

PLAYER INFORMATION

* First Name:

* Last Name:

Street:

City:

State:

Zip Code:

Home Phone:

Birthdate:

Email:

Gender:

Grade:

PARENT/GUARDIAN #1

Firstname:

Lastname:

EMail:

Home Phone:

Work Phone:

Cell Phone:

PARENT/GUARDIAN #2

Firstname:

Lastname:

Email:

Home Phone:

Work Phone:

Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

Emergency Contact:

Phone:

Relationship to Player:

Insurance Carrier:

Policy #:

WAIVER INFORMATION

Waiver:

The parent(s)or guardian of the above mentioned child do herby give permission for the participation in any and all activities during NABL 2017-2018 season. We/I assume all risk and hazards incidental to the conduct of the activitiesand do further herby release NABL of any incidentalk risk. We/I also understand that agreements of the gyms prohibit tobacco into these facilities by players or spectators during practice or games. All school policies apply and have to be followed by participates and spectators of NABL.

I/we agree with the above *

* shirt size:

age group:

Signature:

Date:

* indicates required fields

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

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Norris Area Basketball League/Player Registration Form