Clone of Clone of Boys Adidas Jr. SSB Tryouts

1
Athlete 1* This field is required.
First Name
Last Name
2
School & Grade* This field is required.
3
Height
4
Best Contact Email* This field is required.
example@example.com
5
Best Contact Phone (Call/Text)* This field is required.
Please enter a valid phone number.
6
Grade Level* This field is required.
Please Select
Please Select
L
5th & 6th Girls
Middle School Girls
7
Game Headshot* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
8
Parents Name* This field is required.
9
Best Contact Phone?* This field is required.
Please enter a valid phone number.
10
How did you hear about the open runs* This field is required.
Social Media
Friend/Family
Flyer
Website
11
Playing experience* This field is required.
AAU
Basketball Leagues (FBBA, New Territory)
Basketball Camps Only
None
12
🔹 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
13
🔹 Waiver & Release* This field is required.
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
14
🔹 Medical Treatment Authorization* This field is required.
I authorize Htown 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
15
🔹 Insurance Responsibility
I understand that Htown 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.
16
Parent/Guardian Signature
17
Any additional comments or needs we should know about?* This field is required.
18
Date Signed
Date
Month
Day
Year
19
My Products
prevnext( X )
My Bag
1
My Bag
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
ORDER SUMMARY
Total costUSD
Open Runs

Edit
Back
1
1
2
3
4
5
6
7
8
9
10
Quantity
Pay Via Zelle or Cash
Pay via zelle: 832.361.1932
Edit
Back
Total cost
20
Payment Methods
Fastlane Checkout
Choose from one of the PayPal options to make your payment.
Contact Info
Payment Info
Should be Empty: