Basketball League Registration Form

SZN:00 Hoopist Digital League
Athlete Information
Player Name*

First NameLast Name
Are you over 18 ?*

YesNo
Cell Phone
E-mail*
example@example.com
Basketball skill level*

1

2

3

4

1 is Beginner, 4 is Advanced
Court Preference?

Indoor CourtOutdoor Court
I would like to play on the same team with following players. League organizers will form teams base on this buddy list and your skill level.
Important Notes

· Dress appropriately.

· No food or drink in the gym.

· Keep the gym clean.
Emergency Contact & Health Insurance Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*
Do you have health insurance ?

YesNo, I'll pay with cash.
Insurance Carrier
Name of Policy Holder
Subscriver ID/Group Number
Card Number / Card Date
Does you have any allergies, chronic illness, or medical conditions that would limit high level activtiy?*

YesNo
Please describe
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
Confirmation E-mail*
example@example.com
Signature*

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SZN:00 Hoopist Digital League