Albert Lea Girls Youth Basketball 2020-2021 Season Registration Form

Athlete Information

Athlete's Name *

First Name Last Name

Birth Date

Month Day Year

Grade *

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Parent/Guardian Information #1

Name *

First Name Last Name

Home Number

Cell Number *

E-mail *

example@example.com

Parent/Guardian Information #2

Name

First Name Last Name

Home Number

Cell Number

E-mail

example@example.com

Emergency Information

Emergency Contact's Name

First Name Last Name

Relationship

Phone Number

Alt. Phone Number

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by ALGBBA . I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless ALGBBA and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from events.

In case of injury to said child, I hereby waive all claims against ALGBBA. including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including basketball. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

Medical Release and Authorization

I give my permission for my daughter to play on the Albert Lea Girls Basketball Boosters Association (ALGBBA) Team. I acknowledge that playing on the traveling team could lead to injuries because of factors inherent in this type of physical activity. I absolve the ALGBBA and the people associated with the ALGBBA (including, but not limited to coaches, parents, and financial backers) from any liability or blame from any and all injuries, accidents, damage which may occur during the ordinary course of the activity. If any injury occurs that requires the assistance of a physician, I give my permission to the coaches to seek proper medical treatment.

Permission to Publish

The law requires that we ask for your permission to use information about your child.

ALGBBA requests permission for your daughter's photo/image, and personally identifiable information, including jersey number, first / last name, and grade level to be published on the ALGBBA website, Facebook page and/or Albert Lea Tribune.

Registration Fees and Fundraising

I agree to pay the designated registration fees based on 2020-20201 school Grade and participate in fundraising to the best of your ability

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Would you be interested in playing out of town tournaments if we are able to play in them?

YES NO Need More Information

Albert Lea Girls Youth Basketball Registration