CT Stallions AAU Basketball
2017 Registration Form
Please use separate form for each player. (PARENT SIGNATURE REQUIRED ON EACH FORM)
Name Full (Child): ______H/Phone: ______Cell: ______
Address Full:______City______Zip: ______
DOB: ______Age: ______Current Grade: ______Uniform Size: ______
Parent/Legal Guardian: ______Relationship: ______Cell: ______
Parent: ______Relationship: ______Cell: ______
Emergency/Contact: ______Relationship:______
Address: ______Phone: ______Cell: ______
Existing Medical Condition: ______
**Please attach any additional medical information to this form**
Medical Release, Parental Permission & Consent Agreement: I hereby give my child permission to participate in the CT Stallions AAU basketball program. I understand that the sport basketball is physically demanding, carries significant risk of personal injury, in some cases very severe injury, even death, but I feel my child has the ability needed to participate and I agree that I am responsible for my own safety.
I hereby agree to the conditions below:
In the event of an emergency and the parent/guardian or emergency contact is unable to be contacted.
I give my permission to have my child transported to the closest hospital or nearby medical facility. I hereby understand and agree that I shall assume full responsibility of any cost over and above that which is not covered by my health insurance. Fully permitted by law I agree to indemnify and hold harmless the CT Stallions AAU Basketball Program, Coaches, Staff and Facility Sites from any injury and damages caused by or resulting from participation in the program. A photo static copy of this waiver form with my signature shall be considered as valid as the original. I declare that I have personal medical coverage and that I have read all of the above and understand this release and waiver and by signing it agree to all its items.
PHOTOS: In the event photos are taken, I hereby give permission for CT Stallions Organization and or Contracted Photographer has right to own and use said photos in promotional literature, including but not limited to, brochures, flyers and website.
You the Parent by signing this agreement will be responsible for your Child Away and Local Game Transportation, Hotel and Food cost. If additional Chargers are occurred due to damages done by your Child to Hotel Room, Game Sites/Gym or Team Van. You will be held accountable for those damages charges. Players going forward will no longer be able to travel without their (Parent(s) or responsible Adult) to remaining Tournaments, If payment remain unpaid by the next Tournament your child will no longer be apart of CT Stallions Basketball Organization and your registration FEE will be forfeit.
Parent/ Guardian Signature (Required): ______Date:______
Athletes Signature (Required): ______Date:______