Potomac Valley Basketball

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ORGANIZATION / TEAM INFORMATION

* Organization Name:

* Team Name:

* Organization AAU Number:

* Organization Contact:

Street:

City:

State:

Zip Code:

* Contact Phone:

* Email:

* Level:

* Gender:

* Grade:

Coach Information

* Firstname:

* Lastname:

* Coaches AAU #:

* EMail:

Home Phone:

Work Phone:

Cell Phone:

Assistant Coach

Firstname:

Asst. Coach's AAU #:

Lastname:

Email:

Home Phone:

Work Phone:

Cell Phone:

* How Many Games are you looking for?:

* Scheduling Requests (Include the date):

* Is your Team available for Friday Evening Games?:

WAIVER INFORMATION

- ALL TEAMS AND PLAYERS MUST BE CURRENTLY REGISTERED AS FULL AAU MEMBERS in order to participate

- Open to all Girl / Boys teams from 2nd through 12th Grade (AAU Age / Grade Rules apply) - Will be grouped by grade levels (Grade levels may be combined if necessary for competitiveness)

- Schedules Results, stats and additional information will be posted on this site for convenience.

- Many of the games will be recorded! Making it easier for highlight reals etc.
- The cost will be $65.00 per game.

We understand and agree to all the terms above and give the organization the rights to use any and all information in anyway legal it sees fit. Furthermore we hold harmless and give waiver to any and all harm to the players / coaches as this is an intense sport. We also acknowledge that as AAU members that insurance is in accordance to what has been purchased, and any and all accidents or injuries will be reported immediately and the forms required by the organization, AAU and/or any other party will be completed and all cooperation will be give.

The organization agrees to provide all above for any and all participants that pay in full.

All Fees are Non-Refundable.

I/we agree with the above *

* Signature:

* Organizational Position:

* Authorizer's Email:

* indicates required fields

Request additional game same team (2 Games Total) +($75)

Request 2 additional games (3 Games Total) +($150)

Quick Req. (Less than 8 days notice)($25)

Credit Card Fee (To Avoid Fee, at end choose pay offline, then pay via Paypal to mdaau@hotmail.com)($9) *

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