AAU Club Membership Registration Form

N64 OFFICIAL AAU MEMBERSHIP REGISTRATION FORM
Current Grade for March 2025*
Athlete Name*

First NameLast Name
Parent Name*

First NameLast Name
Parent's E-mail*
Parent's Phone Number:*

Area CodePhone Number
Athlete's E-mail*
Athletes Phone Number*

Area CodePhone Number
Age*
Gender*
Grade*
JERSEY SIZE*
Please select the right jersey size as we won't be able to exchange them out for others.
SHORTS SIZE*
Jersey # Request*
Please note that you will have to get a new # if someone from last year on the same team as your number.
Alternative # Request*
Select another number in case the first # is unavailable.
Birth Date:*

MonthDayYear
School Attending*
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
A Friend or colleaugeGoogleSocial Media (Facebook, Instagram, Twitter)School CoachOther
Release of Liability/Refund Policy
Release of Liability & No Refund Policy
I, the undersigned parent or guardian, authorize National Super 64 Exposure Showcase LLC to secure necessary medical treatment for my child in the event I cannot be reached. I also grant permission for any attending physician to provide medical care deemed necessary. Every effort will be made to contact me before any treatment is administered.

I certify that my child is physically fit to participate in the National Super 64 Exposure Showcase program, including all basketball-related activities such as strength training, speed drills, and agility exercises.

I hereby release National Super 64 Exposure Showcase LLC and all affiliated entities from any liability, claims, or demands related to personal injury or loss that may occur during program participation. Additionally, I acknowledge and agree to the NO REFUND policy for any payments made to the program. However, if the season is canceled due to COVID-19, I understand that I am entitled to a pro-rated refund based on the number of practices, games, and tournaments my child has participated in.

I also acknowledge that while participating in the basketball program, I am responsible for safeguarding any personal belongings stored in the facility’s locker room. I agree to take all necessary precautions, such as securing my belongings with a personal lock. I understand that only essential items for program participation should be stored in the locker. I fully waive any claims of liability for lost, stolen, damaged, or destroyed personal property while participating in the program.

By signing below, I confirm that I have read, understood, and agreed to the terms outlined in this release.
I have read, understood, and accept the RELEASE OF LIABILITY &REFUND POLICY for membership.
Signature*

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My Products*
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AAU Fee - First Year Player ($575 + $25 Online Fee)$600.00
Skip the line and pay now.

AAU Fee - First Year Player $575 - I'll Pay In Full Onsite$ Free
I'll bring a check or cash onsite

AAU Fee - First Year Player ($500 + $75 Jersey Fee + $25 Online Fee) & Sibling (50% off) ($250 AAU Fee + $75 Jersey)$925.00
Sibling Discount 50% Off

AAU Fee - First Year Player ($500 + $75 Jersey Fee) & Sibling (50% off) ($250 AAU Fee + $75 Jersey)$900.00
Sibling Discount 50% Off

HOW TO INCREASE YOUR SCORING AVERAGE BOOK BY COACH RICKY TAYLOR - DOUBLE MY SCORING AVERAGE$20.00

Quantity
Please list any special notes concerning your final order (different shirt sizes for multiple people). If you don't have any notes, please leave blank.
Thanks for your cooperation!
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N64 OFFICIAL AAU MEMBERSHIP REGISTRATION FORM

Release of Liability/Refund Policy