Clone of Liability Waiver for Tournament League

LIABILITY WAIVER

Fill out the form carefully for registration
Player's Name

First NameMiddle NameLast Name
Mother's Name

First NameMiddle NameLast Name
Father's Name

First NameMiddle NameLast Name
Player's Birth Date

MonthDayYear
School (Current 2024-2025)*
School Grade*
Height*
How did you hear about us?*
Player's Gender
5th-8th Grade MAKEUP Spring Tryouts NDNU- 1500 Ralston Avenue, Belmont CA 94002*

*February 22nd 1:00-2:00 PM
HIGH SCHOOL TRYOUTS NDNU- 1500 Ralston Avenue, Belmont CA 94002

Adidas Gold Tryout: Saturday February 22nd 12:00-2:00 PMAdidas Gold Tryout MAKEUP: Saturday March 1st 12:00-2:00 PM
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Players's E-mail
Mother's E-mail
example@example.com
Father's E-mail
example@example.com
Mother's Mobile Number*

Area CodePhone Number
Mother's Work Number

Area CodePhone Number
Father's Mobile Number*

Area CodePhone Number
Father's Work Number

Area CodePhone Number
Emergency Contact's First & Last Name *
Emergency Contact's Phone Number*

Area CodePhone Number
Please list your previous Basketball experience below*
My child has permission to participate in the Evolution Basketball Club. I hereby assume all risk associated with the participation of my son/daughter in the Evolution Basketball Club, and agree to hold harmless the Evolution Basketball Club, their officers, coaches, and participants for any and all claims for injuries arising out of the participation in the program. I have completed and understand the details of this form and attest to its accuracy. I also give my permission for my son/daughter to be examined by a physician in case of an emergency.
Parent Signature:*

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Please select the date

MonthDayYear
Date
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LIABILITY WAIVER