LITTLE DRIBBLERS BASKETBALL
2015
K – 2nd Grade
Please return to: Jt. Rec. District, l35 N. Detroit St., Bellefontaine, OH 43311
Due in the Office by Friday, October 23, 2015
Player's Name: ______Grade ______BOY _____ GIRL _____ (Mark One)
Street Address: ______Telephone: ______
Email: ______Parent/Guardian Name: ______
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Having been informed of the organization of Youth Basketball in Bellefontaine, Ohio, to provide supervised basketball games for boys/girls, I/we, the parents of the above named player, do hereby give my/our approval to participate in any and all of the activities during the current season. I/we do assume all the risks and hazards incidental to the conduct of the activities, transportation to and from the activities; and I/we do further hereby release, absolve, indemnify and hold harmless the Youth Basketball and the Bellefontaine Joint Recreation District, the organizers, sponsors, and the supervisors, any and all of them. In case of injury to the above named player, I/we hereby waive all claims against the organizers, the sponsors or any of the supervisors appointed by them. I/we likewise release from responsibility any person transporting any above named player to or from the activities.
We, the parents of the above named player, do understand all of the above, and we will furnish the necessary evidence of our child's school district to the Youth Basketball Director upon request.
Parent/Guardian Signature ______Date ______
CIRCLE ONE SHIRT SIZE: Youth: S (6-8) M (10-12) L (14-16) Adult: S M L XL
Office use Only: Amount paid ______Fees: $ 10.00
Initials ______(Checks Payable to: Bellefontaine Youth Basketball)
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Keep this portion for your information
Note: When the schools are closed, Little Dribblers will NOT be in session.
Little Dribblers will meet at the Bellefontaine Elementary School Gym
BOYS Schedule: Monday Evenings 6:00 pm- 7:00 pm Dates: Nov. 2, 9, 16, 30 & Dec. 7, 14
Halftime Performance (BOYS) Saturday, December 19, 2015 @ BHS Girls basketball game vs. Tippecanoe
GIRLS Schedule: Tuesday Evenings 6:00 pm – 7:00 pm Dates: Nov. 3, 12 (Thur.), 17 & Dec. 1, 8, 15
Halftime Performance (GIRLS) Friday, December 18, 2015 @ BHS Boys basketball game vs. Kenton Ridge
For Cancellations or updated information
“Like” us on Facebook – Bellefontaine Joint Recreation District
Or Call our Cancellation Line at 937-651-6009