Me vs Me Basketball Registration Form

Me vs Me Basketball Registration Form
Athlete Information
Player Name

First NameLast Name
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
Age
Grade
Jersey Size
Type in the size needed for player jersey.
Emergency Contact & Health Insurance Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Format: (000) 000-0000.
Do you have health insurance ?
Insurance Carrier
Name of Policy Holder
Subscriber ID/Group Number
Card Number / Card Date
Parental Permission For Emergency Treatment

In the event of illness or accident, I give my permission for emergency treatment by qualified medical personnel for my child, and I authorize the person in charge to take my child to:
I give consent for the facility to secure any and all necessary emergency medical care for my child.
Name of Physician / Emergency Medical Care Facility
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Format: (000) 000-0000.
Assumption of Risk and Waiver of Liability

I acknowledge that while safety is the primary concern, participation in indoor sports activities at the sport facilities carries inherent risks that may result in injury, illness, or death. By participating, I expressly assume all associated risks and agree to waive any right to pursue claims against Sport Center or its staff for incidents arising from these activities.
I have read and agree to the above conditions
Confirmation E-mail
example@example.com
Signature

My Products

High School Spring Participation Fee

$1,241.44 Quantity

Middle School Spring Participation Fee

$827.74 Quantity

Total

Payment Methods

Credit Card

Apple Pay

Cash App Pay

ACH Bank Transfer

Should be Empty:

Me vs Me Basketball Registration Form

Assumption of Risk and Waiver of Liability

My Products

Payment Methods