Basketball League Registration Form

Only "A" Game Registration Form
Athlete Information
Player Name

First NameLast Name
Are you over 18 ?
Guardian / Parents Names

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone
Format: (000) 000-0000.
Cell Phone
Format: (000) 000-0000.
E-mail
example@example.com
Basketball skill level

1

2

3

4

5

1 is Beginner, 5 is Advanced
Important Notes

· Dress appropriately and bring your own basketball if possible.

· No food or drink in the gym.

· Keep the gym clean.
Emergency Contact / Secondary Pick up
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Format: (000) 000-0000.
Does you have any allergies, chronic illness, or medical conditions that would limit high level activtiy?
Please describe
Release of Liability

Although the safety of all sport activities is the primary concern, indoor sport activities at Only "A" Game 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 Ony "A" Game and the persons in charge.
I have read and agree to the above conditions
Confirmation E-mail
example@example.com
Signature
Should be Empty:

Only "A" Game Registration Form