Clone of Clone of Boys Adidas Jr. SSB Tryouts

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Athlete 1* This field is required.
First Name
Last Name
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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
5th Boys
5th & 6th Girls
6th Boys
Middle School Girls
7th Boys
8th Boys
9th Girls
9th Boys
10th Girls
10th Boys
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Game Headshot* This field is required.
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Tryout Selection
Please Select
Please Select
Aug _1 Boys & Girls _ 3pm -5pm (Richmond)
Aug 15 _ Boys 5th - 7th _ 9am - 10:30am
Aug 15 _ Boys 8th - 11th _ 10:30am - 12pm
Aug 15 _Girls 6th - 10th _ 1pm - 3pm
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Parents Name* This field is required.
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Best Contact Phone?* This field is required.
Please enter a valid phone number.
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How did you hear about the basketball camp?* This field is required.
Social Media
Friend/Family
Flyer
Website
12
Playing experience* This field is required.
AAU
Basketball Leagues (FBBA, New Territory)
Basketball Camps Only
None
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🔹 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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🔹 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
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🔹 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
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🔹 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.
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Parent/Guardian Signature
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Any additional comments or needs we should know about?* This field is required.
19
Date Signed
Date
Month
Day
Year
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