Juneteenth 3-on-3 Basketball Tournament Registration

Juneteenth 3-on-3 Basketball Tournament Pre- Registration

Permission To Participate and Hold Harmless - Lenawee County NAACP Branch
REGISTRATION AT 11:00 AM, TIP-OFF AT 12:00 PM FRIDAY, JUNE 19

CROSSROADS COMMUNITY CHURCH PARKING LOT (119 N. BROAD STREET ADRIAN, MI)

TOURNAMENT RULES:
- THREE DIVISIONS: 6-7TH GRADE, 8-9TH GRADE, AND 10-12TH GRADE.
- 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 First and Last Name
Participant Grade
Participant Address

Street Address

Street Address Line 2

CityState

Zip Code
Participant Phone
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Name
Emergency Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.
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 Friday, June 19, 2026. 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:

Juneteenth 3-on-3 Basketball Tournament Pre- Registration