Edgewater Park Athletic Association - (Beverly, NJ)

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2024 Basketball Registration

PLAYER INFORMATION

* Player First Name:

* Player Last Name:

* Address:

* City:

* Home Phone:

* Birthdate:

* Age As of December 1st 2024:

* Gender:

* Grade in the Fall 2024:

PARENT/GUARDIAN #1

* Name:

* EMail (used to send confirmation):

* Cell Phone:

FAMILIES ARE EXPECTED TO PARTICIPATE IN FUNDRAISING TO KEEP OUR EXISTING REGISTRATION FEE
EACH FAMILY AGREES TO ABIDE BY THE EPAA’S CODE OF CONDUCT POLICY.

Please Note-registrations submitted without payment will be null and void within 5 days of being entered.

Please be sure to make contact with an EPAA Board member if you have completed a registration form without payment.
EPAA Board member contact information is available under "Contact Info" menu/link on www.EPAASports.org.

Payment of said registrations must be made within 5 days of completing registration (to secure player roster spot) or the site will
automatically remove/delete said registration. After registration closes, only 50% of registration fees can be refunded.

MEDICAL/EMERGENCY INFORMATION

* Emergency Contact:

* Phone:

* Family Physician:

* Physician Phone Number:

Indicate specific medical allergies, chronic illnesses, or other medical conditions that coaches and medical personnel should be aware of: (Physician Release to Play Required for any ailments listed):

* League for Child to Play In:

* Shirt Size:

Check below if interested in helping with EPAA activities:

Fundraising

Sponsorship / Sponsoring

Donations

Concessions

Volunteering

Coaching (Subject to Township Ordinance - Background Check)

* Coaching Interest:

I hereby give approval for the participation of my child in any and all affiliated associations or league activities and I assume all risk and hazards incident to such participation including transportation to and from said activities. I waive, release, absolve, indemnify, and agree to hold harmless the EPAA and affiliated associations, leagues, the organizers, supervisors, officers, directors, board members, participants, and persons or parents supervising or transporting participants to or from such activities, from any claims arising out of injury to my child. I understand that a player who registers with a league is bound to that league for the entire seasonal year unless a transfer is approved for extenuating circumstances. My family agrees to abide by the EPAA’s Code of Conduct & Anti-Bullying/Harassment Policies.

As parent and/or guardian of the player noted above, a minor, I hereby authorize the treatment by a qualified and licensed medical doctor in the event of a medical emergency which, in the opinion of the attending physician, may endanger my child’s life, cause disfigurement, physical impairment or undue discomfort if delayed. This authority is granted only after a reasonable effort has been made to reach me. I hereby grant this release between the dates of October 1, 2024 and March 31, 2025.

This registration and medical release form is completed and signed of my own free will for the sole purpose of authorizing participation in the league and authorizing medical treatment under emergency circumstances in my absence:

*** IMPORTANT *** DUE THE BASKETBALL LEAGUE CHANGES:
EACH PLAYER MUST ATTEND THE SKILLS ASSESSMENT.
THERE ARE NO GUARANTEES ABOUT TEAM PLACEMENT OR PRACTICE SCHEDULES.
COACHES MUST ATTEND MANDATORY COACHES MEETING.

WAIVER INFORMATION

I/we agree with the above *

* Parent/Guardian Name Registering Player:

Other Notes to EPAA:

* indicates required fields