Players Name:     Street:  
City: State:     Zip: Phone:
cell:      Shirt Size: Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult Extra Large Adult XXL   Age:   Grade:    Gender Female
Birth Date:     E-Mail   School:

    Green Ridge Girls Basketball League

A Div 6-8th Grade
B Div 4-5th Grade
C Div 2-3rd Grade
D Div K-1st Grade

Im willing to help Coach    Coaches Name:

Im Willing to Sponsor a Team $100  includes sponsors name on Uniforms   Sponsors Name:
 

2nd Child

Players Name:    

  Shirt Size: Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult Extra Large Adult XXL   Age:   Grade:    Gender Female

Birth Date:     E-Mail   School:

    Green Ridge Girls Basketball League

A Div 6-8th Grade
B Div 4-5th Grade
C Div 2-3rd Grade
D Div K-1st Grade

Im willing to help Coach    Coaches Name:

Im Willing to Sponsor a Team $100  includes sponsors name on Uniforms   Sponsors Name:

Starts Saturday Nov 5th 2011
Clinic C & D Level 9:30am .     “B” age group 10:45am “A” age group 12:00pm

Games Played Sat Mornings – Early Afternoon at Backcourt Hoops Riverfront Sports Complex
$45 per child 2nd child in same family $40 3rd $35

Comments 

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Health Insurance Co.      Group #: Policy #:
My child is in excellent physical health and capable of participating in strenuous physical activity, and waive Backcourt Hoops of any and all responsibilities for injury or illness. I hereby authorize the director of Backcourt Hoops to act for me according to their best judgment in any emergency requiring medical attention. I understand that I am solely responsible for the payment of any such medical expenses and must provide Backcourt Hoops with proof of insurance. I also understand that my payments are non-refundable, non-transferable under any circumstances.
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