Clone of 2024 CHP Online Tryout Registration Form

2024 Cincinnati Heat Premier Tryout Online Registration

Complete form below to sign up for Tryouts.
FOR ADMIN USE ONLY

Heat Tryout #: _________________
_______________________________________________________________________________
Today's Date

MonthDayYear
Grad Year
Gender*
Grade*
First Name*
Last Name*
Specific School*
(Just name...no need for HS or Jr. High)
School District*
Height
Birth Date*

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email - Parent:*
Second Email
example@example.com
Home Phone

Area CodePhone Number
Cell Phone*

Area CodePhone Number
E-mail - Player
Parent / Guardian Name*
_______________________________________________________________________________

INSURANCE WAIVER
We, the parents/guardian the above mentioned child, hereby agree and give our permission for our daughter/son to play basketball for the Cincinnati Heat Premier. We also sign this form to confirm that we will not hold the team organizers, coaches, supervisors, administrators, of any and all playing courts and facilities, responsible for any and all injuries during games, practices and all traveling to and from at all times.
Adult*
Date

MonthDayYear
Does your daughter/son have accidental medical insurance coverage?
YesNo
Insurance Provider
Policy #
In the event of an emergency, please call
Person*
Relationship*
If Other, please enter Relationship
Phone Number*

Area CodePhone Number
We assume all risk and responsibility.

If no, you realize that the Cincinnati Heat Premier and any of the people, persons and organizations stated above not be carrying or supplying any insurance to cover your daughter in case of injury.
Checking the box below acknowledges the terms and conditions for the Cincinnati Heat Premier as shown on the insurance waiver at - Insurance Waiver
I agree to {terms & conditions} Cincinnati Heat Premier*
_______________________________________________________________________________
To ask questions, please call and leave a voicemail for...

Cincinnati Heat Premier (513-477-0991)

Specifying: Name, Grade and provide two callback numbers

Please speak clearly, slowly and call us back if you do not get a call within 48 hours or visit www.cincinnatiheatpremier.org
Other Notes
Enter the message as it's shown*
Should be Empty:

2024 Cincinnati Heat Premier Tryout Online Registration