SSB Elite - U16's Conference Trials

Venue: Camlington Sporting Club, Learning Village, Highburn, Cramlington, NE23 6BN

Date/Time: Thursday July 25th @ 6-9pm

We are incredibly excited to announce the entry of SSB Elite into the U16's Boys National League Conference!

If you are U16 for the upcoming season and want to be a part of this exciting new opportunitiy, register your palce at our trials.

See you soon!

Louis.

Player’s Name*

First NameLast Name

Player's Age*

Player's Date Of Birth (DD/MM/YYYY)*

Which club are you currently a member of?

Parent/Guardian Information & Emergency Contact

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityCounty

Postal / Zip Code

E-mail*

example@example.com

Emergency Contact Telephone Number*

Alternative Telephone Number

In the event that you don’t answer your primary number

Does the player have any allergies, chronic illness, or medical conditions? If yes, please describe.

Is the player prescribed an inhaler? If yes, please explain any instructions.

YesNo

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by SSB Elite during the selected sessions. In exchange for the acceptance of said child’s candidacy by SSB Elite, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless SSB Elite and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected sessions.

In case of injury to said child, I hereby waive all claims against SSB Elite including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including basketball. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

Medical Release and Authorization

As Parent and/or Guardian of the named player, I hereby authorise the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named player. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to SSB Elite and its affiliates including Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorized on the dates and/or duration of the registered season.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Date*

Date

Signature*

You will be redirected to payment upon submission.

SSB Elite U16's Boys Conference Trials

Payment of £25 for a place at the SSB U16's Boys trials.

£25.00

Total

£0.00

SSB Elite - U16's Boys Conference Trials Registration Form

Player Information