Registration Form

SIBL Level Up, Skills & Drills

Registration Form
Name*

First NameLast Name
Address*

Address

Street Address Line 2

CityState / Province

Zip
Birth date*

MonthDayYear
Date
Age*
Grade*
School
School Graduation Year*
Mothers Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Fathers Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Medical Release Information
To induce the SIBL YOUTH CT/CT FLYERS AAU Program and its representatives to accept registration and permit participation by the above named minor. I hereby give my permission, consent, and agree to release, indemnify, and hold harmless the SIBL YOUTH CT Basketball Program, its officers, coaches, and representatives from any claims arising from any injury and/or Covid 19 to the above-named minor participant. If minor becomes sick, please keep them home! As the parent or legal guardian to the above-named minor participant. Consent for medical treatment as the parent or legal guardian of the above mentioned player. I hereby give my consent for emergency care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well being of my dependent.

Parent Signature: *by signing you are making yourself liable for the fee associated with participation within SIBL YOUTH CT and CT FLYERS Basketball*
Parent Signature*

Clear
Medical Condition*
(if none, type none)
Emergency Contact (other than above):
Name*
Cost: $10 ONE TIME TRYOUT FEE (CASH ONLY PLEASE) ADULTSHIRT SIZE - (circle one)
Cost $10 ONE TIME TRYOUT FEE (CASH ONLY PLEASE) Adult Shirt Size*

SMLXL2XL3XL
Preferred Number*
Pick Three choices. separate with commas ( , )
Program Features

$250/10 week program 2x per week, focused on teaching basketball fundamentals to young boys and girls 3rd - 12TH grade. Conditioning, shooting, ball handling, Each COACH during the session will feature fundamental drills, lessons

on how to succeed in their goals "Preparation for
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SIBL Level Up, Skills & Drills

Medical Release Information