Valpo Hoops Feeder League Signup

Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number
Please enter a valid phone number.
Emergency Contact Name

First NameLast Name
Relationship to player
Emergency Contact Number
Please enter a valid phone number.
Insurance Carrier*
Name of Policy Holder

First NameLast Name
As the legal parent or guardian, in the event of illness or accident, I give consent for the Valpo Boys Hoops LLC and its Staff to secure any and all necessary emergency medical care for my child. The undersigned gives permission to Valpo Boys Hoops LLC and its owners and operators and members of the Valparaiso High School Boys & Girls Basketball Coaching staff to seek medical treatment for the participant in the event they are not able to reach a parent or guardian. I request that my child be transported to Northwest Health Porter Hospital in the event of an emergency. I hereby declare we have listed any physical/mental problems, restrictions, or conditions and/or declare the participant to be in good enough physical and mental health to participate in basketball practice and games.*

Yes
As the legal parent or guardian, I release and hold harmless Valpo Boys Hoops LLC, its owners and operators, and its Coaching Staff, and the Valparaiso Community School Corporation from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant and/or the undersigned, while in or upon the premises or any premises under the control and supervision of Valpo Boys Hoops LLC and Valpo Hoops LLC, its owners and operators or in route to or from any of said premises.*

Yes
Be respectful: Respect players, coaches, officials, and other spectators. Be positive: Cheer for good plays, encourage fair play, and avoid booing the other team. Be supportive: Show team support and recognize good effort. Be safe: Be alert to prevent accidents and respect the safety of children. Be responsible: Be responsible for your own actions and respect the rules of the facility. Avoid disruptive behavior: Don't argue with officials, taunt other fans, or throw items on the field. Avoid harassment: Don't use foul language or harass players, coaches, or officials. Avoid discrimination: Don't discriminate against anyone based on gender, sexuality, ability, cultural background, or religion. Be aware of the rules: Follow the rules and regulations for the event*

I agree to the general spectator code of conduct stated above

If you would like to volunteer as a Coach state your name below.

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Have you coached Valpo Hoops in the past?

YesNo
Please explain your basketball background.

My Products*

2024 Feeder League

$110.00 Quantity

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Valpo Hoops Feeder League Signup

League Dates are as follows: