Juneteenth 3-on-3 Basketball Tournament Registration

Juneteenth 3-on-3 Basketball Tournament Registration

Permission To Participate and Hold Harmless - Lenawee NAACP
REGISTRATION AT 8:30 AM, TIP-OFF AT 9 AM SATURDAY, JUNE 14

119 N. BROAD STREET ADRIAN, MI

TOURNAMENT RULES:
- TEAMS ARE MADE UP OF AGES: 9-11, 12-14, 15-18
- COST: $10 PER PLAYER, UP TO 4 PLAYERS PER TEAM (Cash or check ONLY. Please pay at registration table on morning of tournament.)
- 3-ON-3 (+1 SUB FOR EACH TEAM)
- CO-ED
- FIRST TEAM TO 15 POINTS WINS
- 15 MINUTE RUNNING CLOCK
- DOUBLE ELIMINATION
Participant Name*
Participant Age*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone*
Please enter a valid phone number.
Emergency Contact Name*
Emergency Contact Phone*
Please enter a valid phone number.
Shirt Size (sizes not guaranteed)*
Team Name*
Teammate Names (Please note each team member's parent/guardian MUST submit their own form):*
I, the Parent/Guardian of   Child's First/Last Name* , Child's Age*  knowingly and voluntarily grant permission to participate in the 3-on-3 Basketball Tournament held at 119 N. Broad Street, Adrian MI 49221 on Saturday, June 14, 2025. I further forever release, acquit, hold harmless, and discharge the Lenawee County NAACP
Branch #3162 and the National Association for the Advancement of Colored People (NAACP), its agents, executive committee, and officers from all liabilities, claims and cause of injury sustained during participation in this event.

Signature*

Street Address*      City*   State*   Zip*

Phone Number*

Date*
While participating in the event, my child will be under the direct supervision of:*
Should be Empty: