Basketball Registration Form
Fill out the form for registration
Full Name
*
First Name
Last Name
Telephone
*
Format: (000) 000-0000.
Email
*
Please make sure that this is the email you frequently check
Age
*
Please Select
12 Years Old
13 Years Old
14 Years Old
15 Years Old
16 Years Old
Your T-Shirt Size
*
Please Select
Small (S)
Medium (M)
Large (L)
X-Large (XL)
Two X-Large (2XL)
Three X-Large (3XL)
Emergency Contact Info: (Name & Number of Parent) Must be either Mother/Father or Legal Guardian)
*
I hereby agree to abide by the rules and regulations set up by the Darulhijra Masjid Basketball Team. I further agree to accept complete responsibility in matters of physical injury or loss that might result from such participation in games, practices or travel to or from such activities. I further agree that in the event of such injury or loss, there shall be no liability on the part of the Darulhijra Masjid, Management or Owners of the Facilities used, Darulhijra volunteers or any of the sponsoring bodies associated with the sponsorship of this activity. DARULHIJRA LEAGUE MEDICAL RELEASE In the case of emergency, I authorize the Darulhijra Masjid Basketball Team and/or volunteer coach to give permission for appropriate medical or surgical care for the above named player.
I agree
Submit
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