Schenectady County CYO Basketball

Schenectaday County CYO Non-Affiliate Waiver Form

 This form is to be completed by Diocesan Level CYO programs wishing to have a non-affiliated grade & age eligible player on their roster who resides outside that program’s boundary. For a discussion of grade, age, non –affiliates and boundary (church edifice discussion) see Diocesan CYO Rules published on both The Mater Christi and Schenectady CYO website. The form is to be signed by the parish AD and submitted together with support documentation at the time of initial roster submission. Non-affiliated players that would otherwise require the completion of this form are not allowed to be added to a team’s year roster after the team has played its first regular season league game in the current season.

Player Name: ______________________________________________

Address (city, state zip): _____________________________________

Parent / Guardian Name & Cell phone #: _______________________

Program Requesting Waiver: _________________________________

Team Level (BG, JG, BB, JB): _________________________________

Parishes with Diocesan Level Team Closer to Player Address than Program Requesting Waiver:

1.       __________________________________

2.       __________________________________

3.       __________________________________

      Others: ____________________________________________________________________

For each closer team attach a copy of an email or other written correspondence from the grantor parish granting a waiver to your program for the player for whom the waiver is requested

______________________________________________                     _______________

Requesting AD (sign & print name)                                                                          Date