Last Name (athlete) *:

First Name (athlete) *:

Street Address *:

City *:

State *:

Zip Code *:

Phone Number *:

Email (for confirmation) *:

Parent/Guardian *:

Parent/Guardian Phone *:

School Athlete Attends:

Grade *: - Select - Pre-K K 1 2 3

Event Attending *: - Select - LIL DRIBBLERS IN CLARE CHRISTMAS CAMP 1-3 IN HL CHRISTMAS CAMP 4-6 IN HL

Event Fee *: - Select - LIL DRIBBLERS in Clare, $35.00 CHRISTMAS CAMP 1-3 in HL, $30.00 CHRISTMAS CAMP 4-6 in HL, $30.00

Gender *: - Select - Male Female

Comments/Medical Info:

How Did You Hear Of Us: - Select - Friend Flyer Newspaper Facebook Email Other

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WAIVER AND CONSENT:
I understand that my participation in HOOPZONE Basketball Club involves risks and dangers of serious bodily injury or death. I, or my parent/guardian if I am a minor, hereby release, hold harmless, discharge or agree not to sue HOOPZONE Basketball, Coaches, Volunteers, Owners/Lessors of Premises for all liability from my participation in this activities. . I clearly understand that by entering my athletes name on this form that I am assuming all risk for any injury on or off the court during her involvement.

PERMISSION:
I hereby grant HOOPZONE Basketball full permission to use for publicity and advertising purposes, any photographs or videos taken of participants at their events. Any photographs/videos taken will remain the property of HOOPZONE Basketball only. As the athlete and/or the parent/guardian of this athlete we agree with HOOPZONE Basketball Athletic Code and Rules. By signing this form we acknowledge that we have read and understand this information.

PARENT/GUARDIAN PERMISSION RELEASE TO PARTICIPATE:
By placing my initials below I (as the Parent/Guardian of this athlete) hereby agree to all waiver, consent and permission as noted above.

Parent/Guardian Initials *: <--- This MUST be initialed to participate!

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If adding more than one athlete you can hit the back arrow on your browser bar in the cart to come back here and modify this form to submit a second athlete.

(Payment options at checkout)