WINTER 2025 Sign Up
Westside Premier Basketball League
Player Name
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CHILD's First Name
Last Name
Age :
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Child's Age
Date of Birth
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Month
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Day
Year
Birth Date
Current Grade
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School
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Name of School
Basketball Division
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LITTLE DRIBBLERS (K1 /$275 /Games start at 10:30 every Sunday. Pre-Game practice only!)
GIRLS ROOKIES (3rd / 4th / 5th GRADE)
GIRLS MINORS (6th / 7th / 8th GRADE)
BOYS BALLERS (1st / 2nd GRADE)
BOYS ROOKIES (3rd / 4th GRADE)
BOYS MINORS (5th / 6th GRADE)
BOYS MAJORS (7th / 8th GRADE)
JUNIORS (9th / 10th / 11th GRADE)
Please verify that you are human
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Parent/Guardian Name
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First Name
Last Name
Phone Number
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Email
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example@example.com
Parent/Guardian Name
First Name
Last Name
Phone Number
Email
example@example.com
NOTES :
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COVID-19 / Release of Liability Waiver / Rules to follow
**Signature Required Prior to Player's Participation**
I agree to the following:
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I affirm that I, as well as all household members, do not currently have, nor have experienced the symptoms of COVID-19, including, but not limited to, cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell WITHIN THE LAST 7 DAYS.
I understand that neither WPB League, LLC can be held liable for any exposure to the COVID-19 virus caused by misinformation on this form or the health history provided by each player.
REFUND POLICY: A non-refundable 20% administrative fee plus the card processing fees will be assessed by WPB League, LLC (Westside Premier Basketball League) for any patron granted a refund, change, or transfer before the player evaluations. No Refunds will be issued after the first game of the season. Unless the program is cancelled by WPB League, LLC.
PARENT CONSENT: By registering, you understand that you are giving your authorization to participate in WPB League, LLC programs and all activities therein. You further agree to relieve WPB League, LLC its officer, agents, and employees from any liability for injury to you or your child(ren) resulting from and/or in connection with the activities in this program. You understand that WPB League, LLC carries no insurance. You do hereby authorize WPB League, LLC to act as agent for you and your child(ren): to consent to any x-ray examination, anesthetic, medical or surgical diagnosis, treatment/hospital care which is deemed advisable by, and is to be rendered under the general or special supervision of any physician and/or surgeon licensed under the provisions of the Medicine Practice Act and on the medical staff of a licensed hospital; whether such diagnosis or treatment is rendered at the office of said physician or at said hospital. This authorization is given in advance of any specific consent.
PHOTO/VIDEO RELEASE: By participating in our programs, patrons agree to allow t WPB League, LLC to use photographs, video tapes, and testimonials of participants for use in publicity materials free of any fee or usage charge.
PARENT/GUARDIAN CODE OF CONDUCT: I hereby pledge to live up to my responsibilities as a parent/guardian of a child participating in the WPB League, LLC Sports Program by following the Parent/Guardian Code of Conduct. I will place the emotional and physical well-being of the children above any personal desire to win. I will help my child understand the valuable lessons sports can teach. I will be a role model of good sportsmanship and character. I will help my child meet his/her responsibilities to the coach and the team. I will do my best to make sure that the game is fun for all participants. I will remember not to take the game or myself too seriously. I will lead by example in demonstrating fair play and sportsmanship to all participants. I will treat participants, coaches, recreation administrators, and the public with respect. I will help maintain a sports environment for all participants that is free of drugs, tobacco, and alcohol. I will refrain from their use at all youth sports events. I will make only positive and encouraging comments to players on both teams. I will not interfere or coach from the stands. I will remember that I am a youth sports parent and that the game is for children and not adults. Accordingly, I will encourage my child to play sports by providing a supportive atmosphere, but not pressure them. I will discuss the significance of this code with my family members.
A FEW RULES WE NEED TO FOLLOW EVERY GAMES/PRACTICE 1. No pets allowed in the campus. 2. No Food and Drinks allowed for spectators. 3. Water drinks for players must be placed against the wall of their respective side. 4. Please no parents behind the score bench 5. Please be mindful of the limited parking. When your game is over, please exit promptly. 6. Any warm-up must be done outside. When you enter the gym, be prepared to start the game since we have a tight schedule.
I hereby state that I have carefully read the above waiver. Acceptance and understanding of this agreement are hereby acknowledged. I have read and agree to the Informed Consent and Acknowledgement.
Registration must be fully paid to confirm your child's spot.
FIRST COME, FIRST SERVED
By typing your name below, you agree that you have read, answered honestly, and agree to all above information.
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Failure to sign this waiver will result in non-participation from player and parent.
Date
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Month
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Day
Year
Date
SUBMIT REGISTRATION
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