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Adidas Jr. 3SSB Tryout Registration Form
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1
Athlete 1
*
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First Name
Last Name
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2
Height
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3
Athlete 2
First Name
Last Name
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4
Best Contact Email
*
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example@example.com
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5
Best Contact Phone (Call/Text)
*
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Please enter a valid phone number.
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6
Grade Level
*
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Please Select
8th
7th
6th
Please Select
Please Select
8th
7th
6th
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7
Tryout Selection
Please Select
Girls - 5pm - 6:30
Boys - 6:30 - 8pm
Please Select
Please Select
Girls - 5pm - 6:30
Boys - 6:30 - 8pm
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8
Parents Name
*
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9
Best Contact Phone?
*
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Please enter a valid phone number.
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10
How did you hear about the basketball camp?
*
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Social Media
Friend/Family
Flyer
Website
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11
Playing experience
*
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AAU
Basketball Leagues (FBBA, New Territory)
Basketball Camps Only
None
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12
What skills are most important for your child to improve? (check all that apply)
*
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Shooting
Ball Handling
Defense
Basketball IQ
Confidence
Conditioning
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13
🔹 Acknowledgment of Risk
*
This field is required.
I, the undersigned parent/guardian, acknowledge that participation in basketball activities, practices, training sessions, games, and related events with Tx Supreme Fall Ball League (Lead Through Athletics) at 4 Quarters Gym involves risks, including but not limited to: falls, collisions, physical contact, sprains, broken bones, and other injuries. I understand these risks are inherent to the sport and cannot be eliminated.
I do not agree
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14
🔹 Waiver & Release
*
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In consideration of my child’s participation, I hereby release, waive, and discharge Tx Supreme Fall Ball League, Lead Through Athletics, 4 Quarters Gym, coaches, staff, volunteers, and affiliates from any and all liability, claims, or demands for personal injury, property damage, or wrongful death arising from participation in league activities, whether caused by negligence or otherwise.
I do not agree
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15
🔹 Medical Treatment Authorization
*
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I authorize Tx Supreme Fall Ball League and 4 Quarters Gym staff/volunteers to seek emergency medical treatment for my child in the event of injury or illness. I agree to be responsible for any associated costs.
I do not authorize
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16
🔹 Insurance Responsibility
I understand that Tx Supreme Fall Ball League and 4 Quarters Gym do not provide medical insurance for participants and that it is my responsibility to carry appropriate coverage for my child.
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17
Parent/Guardian Signature
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18
What do you value the most in youth sports program?
*
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Fun
Skill Development
Competition
Teamwork
Mentorship
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19
Any additional comments or needs we should know about?
*
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20
Date Signed
-
Date
Month
Day
Year
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21
Are you or do you have any company interested in donating to Lead Through Athletics? (We are a 501c3 nonprofit organization.)
*
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Yes
No
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