PrimeTime Basketball Club

REGISTRATION FORM

LAST, FIRST NAME: / HEIGHT:
PLAYER’S AGE AS OF January 1: / DOB: / WEIGHT:
ADDRESS:
CITY, STATE, ZIP
COUNTY: / HOME TELEPHONE:
SCHOOL: / GRADE:
PARENT(S)
EMAIL ADDRESS:
CELL NUMBER: / ( ) MOTHER / ( ) FATHER

PLAYER INFORMATION

* Best Positions______
* LAST AAU TEAM: ______* Other Sports Played:______
* Elementary School______3rd _____4th ____5th
* Middle School ______6th ____ 7th ____ 8th
* High School ______9th ____ JV ____ V
ANY PHYSICAL PROBLEMS WE SHOULD KNOW OF? _____ NO _____ YES (Please explain):
______

FOR THE PARENTS (Please read carefully)

I, being the parent of the above named child, hereby give my approval for her participation in any and all PrimeTime Elite Basketball activities including tryouts. I assume all risks and hazards incidental to such participation including transportation to and from the activities: and I do hereby waive, release, absolve, indemnify and agree to hold harmless the PrimeTime Elite Basketball, sponsors, organizers, owners of facilities used, supervisors, participants, and coaches for any and all claims arising out of injury to my daughter except as covered by AAU Insurance, YBOA Insurance or Motor Vehicle Insurance.

I hereby authorize PrimeTime Elite Basketball officials, coaches, assistant coaches, team mothers, or any responsible persons delegated to any of the above to take my child to the nearest hospital or any other accredited medical establishment for emergency treatment in case of injury during practice and/or games if the parents are not available. I will assume any and all financial responsibility. I give permission for my child to be used in advertisement for PrimeTime Basketball and PrimeTime Elite Basketball; this includes my child being photographed, video taped and her information (such as stats, etc.) on the PrimeTime website for positive promotion of the program. I understand that fundraising is a requirement of this club. Coaches travel expenses to out of state tournaments is the responsibility of each individual team. I understand I have a duty to return all uniforms at the end of the season. NO REFUNDS ONCE ACCEPTED.

Parent/Guardian Signature: ______Date signed: ______

IMPORTANT INFORMATION (Please complete)

Short Size: ______Jersey Size: ______

Please make all checks payable to: Chris Henderson

Mail to: 752 Farm Hill Court

Woodstock, GA 30188

Further Contact Information: (770) 895-2005

Parental/Player Agreement

I understand the importance of attending practices. I understand my child must practice at home to achieve her full potential.

I understand fundraising is a team effort and I am required to participate.

I understand that events are not mandatory; but participation influences a great team and social skill building experience.

I understand that my child’s improvement is based on their work ethic.

I understand this is a competitive team. I understand that PLAYING TIME IS EARNED AND NOT GUARANTEED!

I understand that communication is essential to a good relationship with the coach, players, and parents.

I understand the coach can not work miracles but he/she will try. I understand that coaches will make mistakes as they are human.

I have read and understand the direction and vision (see below) of PrimeTime Basketball.

PrimeTime Basketball’s vision is to establish a vigorous and challenging program that will increase the mastery of the participants playing ability, academic progression and social skill building. The primary goals of PrimeTime Basketball are the development and strengthening of the overall player and prepare them for life. PrimeTime Basketball Program will be based out of Metro- Atlanta area and will focus on ages 8-17.

PrimeTime Basketball’s concept is to create collegiate individual on all levels. The program focuses on academic expectations and the structure of social skills. PrimeTime will prepare players and present them with the necessary skill for evaluations based on the criteria on which they will be judge by their choice of colleges. PrimeTimeis aware of the lack of quality programs in the area of youth basketball, thus PrimeTime is committed to meeting the challenges and providing a program of substance centered on these beliefs.

Signature______Date______

“We excel @books and ball”

PrimeTime