For full functionality of this site it is necessary to enable JavaScript.
OUR SERVICES
FREE
Web Sites
FREE
Online Registration
Payment Processing
LeagueLineup Pro & Elite
Domain Names
Background Checks
LOCAL SPORTS
Find a Web Site
Tournaments
Team Tryouts
Sports Photographers
ELITE
LeagueLineup Elite
Create your own site
Close Panel
Welcome to the home of the
AUSA Rampage
Login
MyLeagueLineup
Administration
Login
MyLeagueLineup
Administration
°F
Welcome
About
Bulletin Board
Photo Albums
Contact Info
Sponsors
Teams & Rosters
Teams/Rosters
Schedules
Calendar
Tournaments
Directions
Results
Game Results
Forms
Online Forms
Handouts
More
Guestbook
Search
Video Training
Arcade
Pages
About AUSA Basketball
AUSA Basketball Principles
Tournament Info
Videos
Summer League
Login
MyLeagueLineup
Administration
Subscribe to our Newsletter
Young Ladies of Tomorrow
PLAYER INFORMATION
*
First Name:
*
Last Name:
Street:
City:
State:
Zip Code:
*
Home Phone:
*
Age:
Birthdate:
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
*
Email:
Gender:
M
F
Weight:
*
Shirt Size:
Grade:
K
1
2
3
4
5
6
7
8
9
10
11
12
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
I hereby voluntarily permit me or my child to participate in the 2024 ALABAMA USA (YEA) Summer Basketball Program. I UNDERSTAND AND FULLY ACCEPT THAT THERE ARE RISKS INVOLVED IN SPORTS, AND THAT ACCIDENTS AND INJURIES ARE COMMON AND ARE ORDINARY OCCURRENCES OF SPORTS. I HEREBY AGREE TO ACCEPT ANY AND ALL RISKS OF INJURY OR DEATH, AND VERYIFY THIS STATEMENT BY PLACING MY INITIALS HERE. _________ Initial Here
As consideration for being permitted by ALABAMA USA (YEA) to participate in these activities, I hereby release and hold harmless ALABAMA USA (YEA), staff, volunteers, designated coaches, and program officials from all liability, and from all actions or claims that I or my child now or hereafter have for damage or injury to me or my child, or to any person or property, resulting from the negligence or other acts of any employees or volunteers in connection with me or my child's participation. I further agree that this waiver, release and assumption of risks is to be binding on the heirs and assigns of the undersigned. I further agree to indemnify and to hold ALABAMA USA (YEA) St. ColumbaMethodistChurch (its officers, employees, agents and volunteers) free and harmless from any loss, liability, damage, cost or expense which they may incur as a result of any injury and/or property damage that I or my child may cause or sustain while participating in this activity. In case of a medical emergency, I hereby give permission to ALABAMA USA (YEA) Staff, Trainers and Volunteers to order treatment for me or my child, including any necessary medical treatment and x-rays. I also hereby give permission to ALABAMA USA (YEA) Staff and Volunteers to disclose the information contained on this form to medical personnel. I understand that an attempt will be made to reach me by phone when a diagnosis is completed. I agree to pay all medical, hospital, or other expenses which my child or I may incur as a result of such treatment.
I HAVE CAREFULLY READ THIS RELEASE AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN ME AND Alabama USA (YEA) Beverlye SIGN IT OF MY OWN FREE WILL.
I/we agree with the above
*
* indicates required fields
IMPORTANT:
Online Payment with credit cards is not active for this form