ATLANTA BATTLECATS

PLAYER QUESTIONNAIRE

PERSONAL INFORMATION

NAME______NICKNAME______

ADDRESS______CITY______STATE______ZIP______

HOME PHONE ______CELL PHONE______

EMAIL______

BIRTH DATE______

ACADEMIC INFORMATION

HIGH SCHOOL______

GRADUATION DATE______

CITY______STATE______ZIP______

COLLEGE______

GRADUATION DATE______

CITY______STATE______ZIP______

MAJOR______MINOR______

WHAT OTHER TEAMS ARE YOU CONSIDERING TRYING OUT FOR? ______

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BASKETBALL INFORMATION

YEARS OF EXPERIENCE: Pro______College______Varsity______JV______Other______

HEIGHT______WEIGHT______

PRIMARY POSITION______

POSITIONS PLAYED ______

CAREER STATISTICS (INCLUDE PERSONALBEST*)

COLLEGE: PPG______*_____ RPG:____*______APG:______*_____ SPG:______*_____BPG:______*______

HIGHSCHOOL: PPG______*_____ RPG:____*______APG:______*_____ SPG:______*_____BPG:______*______

AAU: PPG______*_____ RPG:____*______APG:______*_____ SPG:______*_____BPG:______*______

BASKETBALL HONORS______

______

COLLEGE COACH______PHONE #______EMAIL______

HIGH SCHOOL COACH______PHONE #______EMAIL______

SUMMER/CLUB TEAM______

SUMMER/CLUB COACH______PHONE #______EMAIL______

OTHER SPORTS:

1. SPORT______POSITION______HONORS______

______

2. SPORT______POSITION______HONORS______

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WAIVER

By signing below, I understand and acknowledge that as a part of my participation with Atlanta BattleCats, there are dangers, hazards and inherent risks to which I may be exposed, including the risk of serious physical injury, temporary or permanent disability, and death as well as economic and property loss. I hereby voluntarily assume all risks of accident or injury to my person or property, whether foreseen or unforeseen. I hereby release the Atlanta BattleCats, Inner Good Health & Fitness Inc., and The Salvation Army, its employees, agents and representatives from any claim, liability demand, or suit or any kind sustained. This release shall be binding upon my heirs, administrators, executors and assigns. Should I incur an injury during participation in tryouts, I consent to receive emergency medical treatment.

I also acknowledge that prior to signing this release, waiver and assumption of risk, I have had an adequate opportunity to read it and any questions I had were directed to the appropriate Atlanta BattleCats personnel and have been answered to my satisfaction. I represent that I am of lawful age and legally competent to sign this release; that I understand that the terms herein are contractual and that I have signed this document as my own free act.

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Signature of Participant Date

PLEASE RETURN TO:

ATLANTA BATTLECATS

634 STONECREEK WAY

STONE MOUNTAIN, GA 30087