Basketball Commitment Form

Steelers Elite Basketball Club
2025 Boys Spring/ Summer Season Registration Form

Please fill out the secure online registration form below for each athlete. Following submission, you will be redirected to make payment for the registration/commitment fee through our online payment portal. The athlete's spot will only be reserved upon receipt of payment of first month fees and uniform package. Form Must be Completed before end of tryouts. If you have any questions, please feel free to contact us at steelersbasketballeliteclub@gmail.com.

Athlete Information

Athlete's Full Name*

First NameLast Name

Date of Birth

Date

School Current Grade*

Athlete's Current Age*

Current School Attending*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Uniform Information

T-Shirt/Jersey Top Size*

Shorts Size*

Jersey Number Requested

Alternate Number

Parent/Guardian Information

Full Name*

First NameLast Name

Cell Number

Area CodePhone Number

E-mail*

Full Name*

First NameLast Name

Cell Number

Area CodePhone Number

E-mail*

example@example.com

Emergency Information

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Area CodePhone Number

Alt. Phone Number

Area CodePhone Number

Does the athlete have any allergies, chronic illness, or medical conditions that would limit high level activtiy?*

YesNo

Please describe.*

Is the athlete prescribed an inhaler? If yes, please explain any instructions.*

YesNo

Please explain any instructions.*

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities of Steelers Elite Basketball club during the selected session. In exchange for the acceptance of said child’s candidacy by Steelers Elite Basketball club, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Steelers Elite Basketball club and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of travel to, participating in, or returning from practices, exhibitions or competitions conducted during the season.

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.

In case of injury to said child, I hereby waive all claims against Steelers Elite Basketball club including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event.

Furthermore, all images and videos of Steelers Elite Basketball club players are the property of Steelers Elite Basketball club and can be used for any promotional consideration.

I hereby state that I have carefully read the above waiver. Acceptance and understanding of this agreement are hereby acknowledged.

I have read and agree to the Informed Consent and Acknowledgement.

Please initial*

Medical Release and Authorization

As Parent and/or Guardian of the named athlete, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to the Steelers Elite Basketball Club Director/Coach/Team Parent to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorized on the dates of the registered sessions.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

I have read and agree to the Medical Release and Authorization.

Please initial*

Program Policies and Terms

Refunds will only be provided, regardless of reason, up to 72 hours after registration and prior to the start of the first practice if a player chooses not to participate. Notification of non-participation must be given to the Steelers Elite Basketball Club by email. Emails should be sent to steelersbasketballeliteclub@gmail.com. An acknowledgement email will be sent to verify withdrawal from the program was received. Within 24 hours to the start of the second practice, refunds will not be given, regardless of circumstances.

SEASON:

If placed on a team and player accepts, payment for the full program fee is deemed due and owing to Steelers Elite Basketball Club and fully earned by Steelers Elite Basketball Club upon the athlete's acceptance into the Steelers Elite Basketball Club program.

There are NO REFUNDS or CREDITS for the program fee if an athlete voluntarily chooses not to continue with the Steelers Elite Basketball Club program or is removed from an Steelers Elite team due to disciplinary conduct prior to the end of the season.

Additionally, any athlete who voluntarily leaves the program or is removed from a team prior to the end of the season will be responsible for immediate payment of any remaining balance due on their account including the FULL program fee.

Furthermore, if placed on an Steelers Elite team and upon acceptance of the athlete, a parent/guardian and/or guarantor must agree to our FULL Policy and Terms Agreement, which will be provided at the time of team selections. This must be completed prior to the athlete being fully accepted into the program.

I have read and agree to the Program Policies and Terms.

Please initial*

Confirmation

By entering the information 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.

Parent/Guardian Full Name*

First NameLast Name

Parent/Guardian Signature*

Confirmation E-mail*

After completing this form, please click Submit Form. You will receive a confirmation email. If you do not receive the email within a few minutes, please check your spam; otherwise, please contact us at Steelersbasketballeliteclub@gmail.com.