🏀Youth Basketball Player Registration Form
(For Participants Under 18 Years Old)
PLAYER INFORMATION
Full Name
Date Of Birth
-
Month
-
Day
Year
Grade
School
Jersey Number Preference
Youth
S
M
L
XL
Adult
S
M
L
XL
Shorts Size
Youth
S
M
L
XL
Adult
S
M
L
XL
PARENT/GUARDIAN INFORMATION
Parent/Guardian Name
Relationship to Player
Phone Number
Email
EMERGENCY CONTACT
(If different from above)
Name
Phone Number
Relationship
MEDICAL INFORMATION
Any allergies, conditions, or medications?
No
Yes
Primary Care Physician
Insurance Provider
Policy Number
PHOTO & VIDEO RELEASE DISCLAIMER
I hereby grant permission to Mambas and its representatives to take and use photographs and/or videos of my child during practices, games, events, or any team-related activities. These images or recordings may be used for promotional purposes, including social media, website content, team marketing materials, or training content.I understand that these images or recordings will not be sold and that my child’s full name will not be used without further consent.
I DO NOT AGREE to the Photo & Video Release
I DO NOT AGREE to the Photo & Video Release
PARENT/GUARDIAN CONSENT & SIGNATURE
I, the undersigned, certify that I am the legal parent or guardian of the participant and that all information provided is accurate. I acknowledge and understand that participation in basketball activities carries a risk of injury and agree to hold harmless the organizers, coaches, staff, and facility from any liability.
Signature
Print Name
Date
-
Month
-
Day
Year
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