REGISTRATION FORM

Player Info

Last Name____________________ First Name ___________________ Phone _________________________

 

Address______________________________ City _____________ State _____ ZIP _____________________

 

Ht _______Wt(optional) __________ Birth date __________ (A copy of your child’s birth certificate is required)

 

Age ___________________________

 

Email _________________              Pager________________                 Cell____________________________

 

Current School ________________________ Probable High School _________________________________

 

Current G.P.A. ________________________ a current copy of report is required.  A GPA of 2.0 is required to

 

Participate as a team member of Rage AAU Girls Basketball.

Parent/Guardian Emergency Contacts

 

Mom_________________________ Wk Phone _________________ Home Phone _______________________

 

Email ___________________________ Pager_____________________ Cell ___________________________

 

Dad__________________________ Wk Phone _________________ Home Phone _______________________

 

Email ___________________________Pager_____________________ Cell____________________________

 

Other_____________________________________________ Contact Phone____________________________

 

Email ___________________________Pager_______________________ Cell___________________________

 

Health Insurance carrier__________________________ Physician_____________________________________

 

Medical #_____________________________________Health Conditions_____________________________

Note: All families will be required to Volunteer 6hrs of time.  

I grant permission for my child to play basketball and will assume all risks caused by injuries due to participation, including transportation to and from activities. Futurehoops Academy will not be held liable for injuries that an athlete might sustain. I also agree to perform volunteer duties as requested by Futurehoops Academy coaches and staff. I grant permission to Futurehoops Academy coaches/staff to consent to emergency treatment for my child until a legal guardian can be contacted. 

 

SIGNATURE ________________________________________ DATE ________________