Tryout Registration & Waiver 2025

Tryout Registration

Thank you for your interest in the Pee Dee Dominators. We are the team where hustle and heart sets us apart! Our mission is to develop young athletes mentally, physically, and morally to their fullest potential through the sport of basketball. Tryouts will be held Saturday, February 22nd for our summer travel basketball season.
Athlete Information
Name*

First NameLast Name
Birth Date

MonthDayYear
Grade*
Parent/Guardian Information
A. Name*

First NameLast Name
A. E-mail*
example@example.com
A. Home Number
A. Cell Number*
B. Name

First NameLast Name
B. E-mail
example@example.com
B. Home Number
B. Cell Number
Emergency Information
Name*

First NameLast Name
Relationship*
Phone Number*
Alternative Phone Number
Does the athlete have any known medical conditions and/or allergies?

YesNo
If yes, please explain.*
PERMISSION FORM, LIABILITY WAIVER AND RELEASE, AND AUTHORIZATION FOR MEDICAL TREATMENT

As the legal guardian, I hereby approve my child’s participation in any and all activities prepared by the Pee Dee Dominators program.

I recognize that 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.

In case of injury to said child, I hereby waive all claims against the organization, including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. I assume all risks and hazards incidental to the conduct of the activities and release, absolve, and hold harmless this organization, all its respective officers, agents, and representatives from any and all liability for injuries to the said child arising out of traveling to, participating in, or returning from any activities.

I understand that this is the express intent of the Pee Dee Dominators program, to provide for the safety and protection of my child, and, in consideration for allowing my child to participate in the Pee Dee Dominators program, I hold the club harmless. I hereby forever release the Pee Dee Dominators program and its Directors, Coaches, Trainers and staff, AAU Boys and Girls Basketball, and/or any facility used by the Pee Dee Dominators program, its officers, employees, coaches, and owners from all liability for any damages and injuries suffered by my child while under the instruction, supervision or control of any of the above so mentioned.

As legal guardian, I hereby agree to individually provide for the possible future medical expenses that may be incurred by my child as a result of any injury sustained while participating in the Pee Dee Dominators program, AAU Boys and Girls Basketball, and/or any facility used by the Pee Dee Dominators program and its officers, employees, coaches, and owners.

In case of an emergency, I authorize Pee Dee Dominators staff to administer first aid to my child and/or take my child to a physician or hospital for further treatment. This acknowledgment of risk and waiver of liability, having been read thoroughly and understood completely, is signed voluntarily as to its content and intent.
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.
E-Signature*

First NameLast Name
Today's Date

MonthDayYear
Date
Should be Empty:

Tryout Registration

Athlete Information

Parent/Guardian Information

Emergency Information