Midnight Basketball League Registration Form

Midnight Basketball League Registration Form-1901 Mississippi Ave. SE. Washington DC. 20020

Starts June 6,2025 @7pm
Participant Information
Players Name*

First NameLast Name
E-mail
Email of Player
Age?*

14-1819-2425 & up
Guardian / Parents Names-(If over 19 just repeat name and fill out address below)*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Ward *
Home Phone*
Cell Phone
E-mail*
example@example.com
Size for Uniform Jersey
Important Notes

- Dress appropriately.

- Keep the gym clean.

- No Fighting

- No profanity.
Emergency Contact Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*
Does the participant signing up have any allergies, chronic illness, or medical conditions that would limit high level activtiy?*

YesNo
If yes, please describe
Parental Permission For Emergency Treatment

In the event of illness or accident, I give my permission for emergency treatment by qualified medical personnel for my child, and I authorize the person in charge to take my child to:
I give consent for the facility to secure any and all necessary emergency medical care for my child.
Name of Physician / Emergency Medical Care Facility*
Phone Number*
Release of Liability

Although the safety of all sport activities is the primary concern, indoor sport activities at Sport Center's facilities may cause injuries and/or death. I expressly assume the risk of injury, death, and/or illness arising from any cause, and agree to waive the right to pursue any claim against the Sport Center and the persons in charge.
I have read and agree to the above conditions*

YesNo
Signature*

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Midnight Basketball League Registration Form-1901 Mississippi Ave. SE. Washington DC. 20020

Release of Liability