A.C.T.S Basketball League

A.C.T.S Basketball League

Coach Registration Form
Coach Information
Coach name*

First NameLast Name
YesNo
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
Basketball IQ Level*

1

2

3

4

5

1 is Low, 5 is High
Please use this space to include any coaching experience if applicable.
Important Notes

· Dress appropriately.

· No food or drink in the gym.

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

First NameLast Name
Relationship*
Phone Number*
Format: (000) 000-0000.
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.
YesNo
Confirmation E-mail*
example@example.com
Signature*

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