Basketball Registration

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SCYBA Basketball Registration

Please read and complete the registration form below:

NOTICE: Your registration is incomplete without full payment. A Registration form must be completed and full payment received before the child will be allowed to participate in any (SCYBA) activities. Make all checks or money orders payable to SCYBA. There is a $30.00 fee for all returned checks:

Players Full Name:
Parent / Guardian Full Name:
Sex:
Size:
Birthday:
Age as of Sept 1, 2009:
Address Street :
Apt:
City:
Zip Code:	(5 digits)
State:
Daytime Phone:
Evening Phone:
Email:
Father's Full Name:
Father's Phone:
Comments or Medical Conditions:	Enter comments here!
	Waiver

PLEASE READ CAREFULLY AND CHECK IF YOU AGREE AND UNDERSTAND THIS WAIVER

WAIVER AND CONSENT: Of the child listed above; do hereby agree to adhere to the Rules and Regulations of the SCYBA. I also agree to conduct myself in a manner reflecting the purpose and intentions of this Association: SPORTSMANSHIP AND FAIR PLAY, at all Association functions. I agree that no refunds will be given after draft day on October 14,2009.

MEDICAL RELEASE: By checking above, I also certify that I hereby grant permission to the adult coach, assistant coach or any league official of the SCYBA to obtain medical care for the child listed above; from any licensed physician, hospital or medical clinic at such time as either parent or legal guardian cannot be contacted in person or by telephone. This authorization shall include all league activities, including the period required to travel to and from the activities; and I do hereby waive the SCYBA, coaches, participants and those persons transporting the player to and from those activities, from any claim arising out of an injury to that player.

MEDICAL INSURANCE: By checking above, I acknowledge that I understand that the SCYBA does not provide medical insurance to the participants of this recreational basketball league. While BBC will make every attempt to ensure that its activities are carried out in a safe and responsible manner, I understand that my child will be participating in a sports activity that may cause physical injury; and that I will be responsible for all medical expenses resulting from such injury; and that I will not hold (SCYBA) or its coaches responsible for any injury to my child.